Endocrine Abstracts

Introduction: – Sheehan syndrome (SS), or postpartum pituitary necrosis, is a rare but potentially serious complication of postpartum. – SS remains an important cause of hypopituitarism in Morocco.– The aim of this study is to evaluate the metabolic profile of patients with SS.

Materials and methods: – This is a retrospective descriptive study conducted in the endocrinology department, spread over a period of 12 years, between the year 2010 and 2022, The data were collected on a data sheet based on the analysis of medical records (paper and computer) and telephone calls if information was missing.

Results: – We collected 28 patients followed for Sheehan’s syndrome during the study period from 2010 to 2022, The average age was 47±7 years with extremes ranging from 35 to 81 years, All patients explored had a thyroid insufficiency, Corticotropic insufficiency was found in 27 patients, Prolactinemia was low in 20 patients with a mean level of 2.6±1.65 ng/ml, 23 patients had a disturbed gonadotropic balance, The somatotropic axis was not explored in our patients, None of the patients had diabetes insipidus. The average BMI of the patients was 28 kg/m²±4.89, and the average waist circumference was 95.7±4.34 cm, HTA in 3 patients, Five patients had a blood glucose level < 0.8 g/l. The rest of the patients had correct blood glucose levels. One case of diabetes mellitus revealed during the follow up, Hypercholesterolemia was found in 13 patients (46.42%). All patients had a pituitary MRI which revealed: an empty sella turcica in 15 patients, 1 case of anteropituitary hypotrophy.

Discussion: – The results of our study agree with those of the literature and show an overexposure to metabolic syndrome in patients with SS.– This metabolic syndrome is related to the associated anteropituitary deficits:– GH deficiency is associated with: Dyslipidemia, Obesity and body composition changes, and hypertension. Thyrotropic deficiency is associated with: HTA, An increase in total cholesterol, LDL, and triglyceridemia. The impact on HDL is more controversial.– Gonadotropic deficiency is associated with: Change in body fat distribution from gynoid to android, Dyslipidemia, Disorder of carbohydrate metabolism, and HTA.

Conclusion: – Reduction of morbi-mortality associated with Sheehan syndrome relies on prevention and early diagnosis especially in our setting. – GH deficiency seems to be at the center of the metabolic abnormalities observed in patients with hypopituitarism.