A 30 years old Mrs. X comes to opd with complaints of lethargy, anorexia, weight loss and secondary amenorrhea. She gives a history of postpaum haemorrhage and failed lactation. Which of the following is the most probable diagnosis?
Correct Answer: Sheehan's syndrome
Description: Sheehan's SyndromeAcute infarction and ischemic necrosis of the pituitary gland resulting from postpaum hemorrhage and hypovolemic hypotension is known as Sheehan's syndrome and is one of the most common causes of hypopituitarism in underdeveloped or developing countries.Failed lactation after delivery is the classical presenting symptom. The rest of the clinical picture varies with the severity of the pituitary insult, ranging from severe hypopituitarism soon after delivery, manifesting as lethargy, anorexia, and weight loss, to secondary amenorrhea, loss of sexual hair, and less severe symptoms of fatigue that emerge weeks and months later.Deficiencies in GH, prolactin, and gonadotropins are most common, although the majority also exhibit ACTH and TSH deficiencies.The evaluation and treatment of Sheehan's syndrome is no different from that for other causes of hypopituitarismReference: Clinical gynecologic endocrinology; 10th edition; Chapter 9; Normal and Abnormal Sexual Development; Page no: 483
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Gynaecology & Obstetrics
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