Sheehan's syndrome: A descriptive case series from a developing country

Abstract

Abstract BACKGROUND AND OBJECTIVES OF THE STUDY Sheehan’s syndrome refers to pituitary ischaemic necrosis due to massive postpartum haemorrhage. It is rarely reported from sub-Saharan Africa despite high incidence of postpartum haemorrhage. The objective of the study was to describe the clinical characteristics of the cases seen by the Endocrinology unit in a tertiary hospital over a period of two years. SUBJECTS, MATERIALS AND METHODS Five cases of Sheehan’s syndrome were seen between March, 2016 and March, 2018. Clinical data was retrieved from the case records and analyzed using SPSSversion 20. RESULTS The age at diagnosis was 36 ± 8.67 years. The median interval between the obstetric haemorrhage and diagnosis was 11 years. Amenorrhoea/oligomenorrhoea, lactation failure, weight loss, excessive tiredness and cold intolerance were found in all the cases. 80% had loss of libido while 60% had loss of hair. 40% had fainting spells. 60% had hypotension. All the patients had anaemia and secondary hypothyroidism. 80% had hypocortisolemia. Hyponatremia was found in 20%. Empty sella was found in 2 out of the 3 (67%) cases that did cranial magnetic resonance imaging. CONCLUSION Sheehan’s syndrome is still rarely seen and diagnosed late as the symptoms are mostly non-specific despite the fact that postpartum haemorrhage is quite common. Menstrual irregularities, lactation failure weight loss and hypothyroidism are common in Nigerian patients.