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 language | English |
|---|---|
| Pages (from-to) | 451-458 |
| Number of pages | 8 |
| Journal | Endocrine Journal |
| Volume | 45 |
| Issue number | 4 |
| Publication status | Published - Aug 1998 |
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Keywords
- Antipituitary antibody
- Empty sella
- Magnetic resonance imaging
- Sheehan's syndrome
- Thyroid autoantibody
- Vasopressin
ASJC Scopus subject areas
- Endocrinology
Cite this
Sheehan's syndrome of more than 30 years' duration : An endocrine and MRI study of 6 cases. / Otsuka, Fumio; Kageyama, Jingo; Ogura, Toshio; Hattori, Teruhiko; Makino, Hirofumi.
In: Endocrine Journal, Vol. 45, No. 4, 08.1998, p. 451-458.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Sheehan's syndrome of more than 30 years' duration
T2 - An endocrine and MRI study of 6 cases
AU - Otsuka, Fumio
AU - Kageyama, Jingo
AU - Ogura, Toshio
AU - Hattori, Teruhiko
AU - Makino, Hirofumi
PY - 1998/8
Y1 - 1998/8
N2 - 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.
AB - 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.
KW - Antipituitary antibody
KW - Empty sella
KW - Magnetic resonance imaging
KW - Sheehan's syndrome
KW - Thyroid autoantibody
KW - Vasopressin
UR - http://www.scopus.com/inward/record.url?scp=0031752470&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031752470&partnerID=8YFLogxK
M3 - Article
C2 - 9881893
AN - SCOPUS:0031752470
VL - 45
SP - 451
EP - 458
JO - Endocrine Journal
JF - Endocrine Journal
SN - 0918-8959
IS - 4
ER -