Sheehan's syndrome of more than 30 years' duration: An endocrine and MRI study of 6 cases

Fumio Otsuka, Jingo Kageyama, Toshio Ogura, Teruhiko Hattori, Hirofumi Makino

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

The endocrine function and pituitary imaging in Sheehan's syndrome more than 30 years after causative events were evaluated. Magnetic resonance imaging (MRI), a combined anterior pituitary test, plasma vasopressin-to- osmolality adaptation study, and antithyroid and antipituitary cell antibody measurement were performed in 6 women with Sheehan's syndrome. The interval from delivery to the onset of symptoms of hormonal deficiency ranged from 3 to 32 years. Since clinical onset, all had received glucocorticoid and thyroid replacement therapy. Cranial MRI examination showed an 'empty sella' in 5 cases. Among these, 2 of 5 (40%) demonstrated panhypopituitarism and the other 3 (60%) maintained gonadotropin response. The pituitary gland was normally discernible but with a low-intensity lesion on T1-weighted images in a patient who maintained PRL and gonadotropin responses. Posterior pituitary function was abnormal in 3 of 6 (50%) despite the absence of polyuria. No antipituitary antibodies were detected in any of the cases. Thyroid peroxidase antibody was negative in all cases, but antithyroglobulin antibody was detected in 2 of 6 (33%). Thyroid-stimulating antibody was not detected, but one case had an anti-TSH antibody. Thirty years after the initial events, most patients with Sheehan's syndrome showed signs of an empty sella on MRI, all having noticeable suppression of anterior and/or posterior pituitary hormones with no related autoimmunity.

Original languageEnglish
Pages (from-to)451-458
Number of pages8
JournalEndocrine journal
Volume45
Issue number4
DOIs
Publication statusPublished - Aug 1998

Keywords

  • Antipituitary antibody
  • Empty sella
  • Magnetic resonance imaging
  • Sheehan's syndrome
  • Thyroid autoantibody
  • Vasopressin

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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