A Case of Sheehan Syndrome Presenting with Pancytopenia and Dilated Cardiomyopathy: A Rare Combination

Abstract

Sheehan syndrome is a rare complication of postpartum haemorrhage resulting in pituitary necrosis and panhypopituitarism. We report a case of a 52-year-old female who presented with easy fatigability, asthenia and loss of appetite for 8-10 months. She was found to have alopecia, hypotension, hypoglycaemia, pancytopenia, and a history of failure to lactate after the last childbirth (17 years back) with premature menopause. The hormone profile revealed panhypopituitarism and magnetic resonance imaging of the brain was suggestive of partially empty sella. Her echocardiogram showed dilated cardiomyopathy with an ejection fraction of 35%. A diagnosis of Sheehan syndrome presenting with pancytopenia and dilated cardiomyopathy was made. The patient was started on injectable hydrocortisone and later, on thyroid hormone supplementation after which she improved. Sheehan syndrome is responsive to hormone replacement therapy and therefore should always be ruled out in such patients.