Endocrine Abstracts (2017) 49 EP937 | DOI: 10.1530/endoabs.49.EP937

Four decades without diagnosis: Sheehan's syndrome, a retrospective analysis

Deniz Gokalp1, Gulistan Alpagat2, Alpaslan Kemal Tuzcu1, Mithat Bahçeci3, Sadiye Tuzcu4, Fatime Yakut5 & Azat Yildirim6


1Department of Endocrinology, Acibadem Medical University, Istanbul, Turkey; 2Department of Endocrinology, Dicle University School of Medicine, Diyarbakir, Turkey; 3Izmir Ataturk Education and Research Hospital, Izmir, Turkey; 4Department of Nuclear Medicine, Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey; 5Department of Radiology, Diyarbakir Memorial Hospital, Diyarbakir, Turkey; 6Azad Yildirim Department of Orthopedics, Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey.


Aim: Sheehan‘s syndrome (SS) remains a frequent cause of hypopituitarism in undeveloped and developing countries, but due to improvements in obstetric care, it is rare in developed countries. We aimed to share the results of a retrospective study analyzing the demographic, clinical, imaging, and hormonal characteristics of a large group of patients with SS, and also increase awareness of this syndrome especially in developed countries.

Methods: The medical records of 124 patients with SS patients who were followed up in the Endocrinology Department of Dicle University between 1995 and 2015 were assessed retrospectively.

Results: The mean period of diagnostic delay was 20.37±8.34 years on average. 5.7% of patients with SS were literate; 62% of patients delivered at home. Anemia was identified in 64.5% of SS patients. Mean blood sodium levels were 129.8±11.3 mEq/L. The mean urine densities were 1013±6.5. Osteoporosis and osteopenia were found in 44 (35.4%) and 71 (57.2%) patients, respectively, According to pituitary magnetic resonance imaging (MRI) analyses, 92 (74.2%) patients with SS had completely empty sella, 29 (23.3%) had partially empty sella, and 1 patient had microadenoma, and 2 had normal pituitary MRI results.

Conclusions: Improved obstetric care and effective interventions for postpartum hemorrhage have limited the prevalence of SS in developed countries. However, in developing countries like Turkey, SS due to postpartum bleeding remains common. Thus, physician’s awareness of the symptoms of SS is urgently required to avoid the associated morbidity and mortality.

Keywords: Hypothalamic amenorrhea, osteoporosis, pituitary gland

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