Sheehan's syndrome

In Sheehan 's syndrome (syn.: postpartum hypopituitarism postpartum Hypophysennekrose ) is rare, occurring after childbirth, complete ( panhypopituitarism ) or partial loss of function of the maternal anterior pituitary ( HVL ) by cell death due to lack of blood supply ( ischemia, necrosis).

As a cause of poor circulation is due to a shock, for example, by loss of blood, was adopted. In rare cases, other severe shock conditions may cause (eg combustion ) to a HVL- necrosis.

The diagnosis is based on the symptoms and is confirmed by the endocrinological diagnosis. According to the normal hormone-producing function of HVL can develop the following symptoms at the destruction of more than 80 % of the hvls:

  • Absence of margin and milk ( lactation, due to loss of prolactin secretion. Often the first symptom )
  • Absence of menstruation ( amenorrhea secondary, due to loss of the hormones FSH and LH)
  • Underactive thyroid (hypothyroidism, due to loss of TSH secretion )
  • Tendency to hypoglycaemia (hypoglycemia, by loss of growth hormone, GH, and by lack of ACTH)
  • Failure of the secondary body hair and
  • Pallor of the skin ( hypopigmentation by MSH deficiency)

Occasionally, the symptoms appear only after years, the relationship to childbirth is then difficult to diagnose. Other causes of a disorder of the anterior pituitary (tumors, trauma, autoimmune reactions) must be excluded.

The HVL can still recover its function even after years. Otherwise, the therapy, the missing hormones, or stimulated by hormones they need to be replaced, possibly for life. Especially the lack of thyroid stimulating hormone TSH and the function limitation of the adrenal cortex by lack of ACTH may, without treatment, cause serious disturbances to coma.

Swell

  • Herold, Gerd: Internal Medicine - A lecture Orient representation, Cologne, 2005
  • Renz - Polster: basic textbook of internal medicine, 3rd edition, Elsevier, Munich 2004
  • Disease in gynecology and obstetrics
  • Disease in endocrinology
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