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Titel: Acute Sheehan's syndrome manifesting initially with diabetes insipidus postpartum: a case report and systematic literature review
VerfasserIn: Olmes, Gregor Leonhard
Solomayer, Erich-Franz
Radosa, Julia Caroline
Sklavounos, Panagiotis
Agne, Philipp
Schunk, Stefan J.
Haj Hamoud, Bashar
Sprache: Englisch
Titel: Archives of Gynecology and Obstetrics
Verlag/Plattform: Springer Nature
Erscheinungsjahr: 2021
Freie Schlagwörter: Sheehan’s syndrome
Diabetes insipidus
Peripartum hemorrhage
Case report
Prolactin
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Purpose Acute Sheehan’s syndrome is a rare, but potentially life-threatening, obstetric event that can be complicated by diabetes insipidus. Little information on the diagnosis and treatment of Sheehan’s syndrome with diabetes insipidus is available. We report on a 28-year-old patient who developed acute Sheehan’s syndrome with diabetes insipidus after giving birth, and on a systematic review of similar cases. Methods We performed a systematic review of the literature cataloged in PubMed and Google Scholar using the keywords “Sheehan syndrome” OR “Sheehan's syndrome” AND “diabetes insipidus” to identify relevant case reports published between 1990 and 2021. Eight Reports met the inclusion criteria (English-language abstracts available, onset in the puerperium, information about the day of the onset). Results In the present case, postpartum curettage was necessary to remove the residual placenta. The total amount of blood loss was severe (2500 ml). On the second day postpartal, the patient developed polyuria. Laboratory analysis revealed hypernatremia with increased serum osmolality and decreased urinary osmolality. Hormone analysis showed partial hypopituitarism involving the thyroid, corticotropic, and gonadotropic axes. The prolactin level was elevated. Brain magnetic resonance imaging showed pituitary gland infarction. Desmopressin therapy was initiated and resolved the polyuria. Hormone replacement therapy was administered. Four months later, the patient was well, with partial diabetes insipidus. The literature review indicated that this case was typical in terms of symptoms and disease onset. Most reported cases involve hypotension and peripartum hemorrhage, but some patients without hemorrhage also develop Sheehan’s syndrome. Elevated prolactin levels are uncommon and associated with poor prognosis in patients with Sheehan’s syndrome. Conclusion Acute Sheehan’s syndrome with diabetes insipidus involves nearly all pituitary hormone axes, indicating severe disease. Prolactin elevation could suggest that a case of Sheehan’s syndrome is severe.
DOI der Erstveröffentlichung: 10.1007/s00404-021-06294-2
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-353932
hdl:20.500.11880/32313
http://dx.doi.org/10.22028/D291-35393
ISSN: 1432-0711
0932-0067
Datum des Eintrags: 3-Feb-2022
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Frauenheilkunde
M - Innere Medizin
Professur: M - Prof. Dr. E.-F. Solomayer
M - Keiner Professur zugeordnet
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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