Sheehan Syndrome

This is a hormone condition found in women following the delivery of a baby. It is characterized by lactation problems following a very traumatic delivery where the woman may have lost a lot of blood and was in hemorrhagic shock, which damaged all or part of her anterior pituitary gland. As the prolactin secreting cells are often damaged, there is a low prolactin level and the breast tissue is not stimulated to produce milk even though the hypothalamus may have sent the right signals to turn prolactin secretion on. Other symptoms of the Sheehan syndrome are loss of pubic hair and axillary hair and a profound fatigue. This is due to low estrogen and low ACTH leading to Addisons disease symptoms.

Pathology

The pathologist would see an infarct in the cut pituitary gland, also called a pituitary apoplexy, of a woman who died from this disease. With special stains the pathologist can show that the hormone production in the area of the infarct had stopped. This leads to the associated endocrinological defects. Using special more sophisticated hormone tests the endocrinologist must determine which of the hormones are missing. Based on these tests appropriate hormone replacement can be given for the rest of the woman's life. In this day and age this is a condition that can be treated. In the past it was a deadly disease.

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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. B. Sears: "The age-free zone". Regan Books, Harper Collins, 2000.

2. R.A. Vogel: Clin Cardiol 20(1997): 426-432.

3. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 8: Thyroid disorders.

4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 7:Pituitary disorders.

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7. ME Flett et al.: Br J Surg 1999 Oct;86(10):1280-1283.

8. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 261: Congenital anomalies.

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11. D Prandstraller et al.: Pediatr Cardiol 1999 Mar-Apr;20(2):108-112.

12. B. Sears: "Zone perfect meals in minutes". Regan Books, Harper Collins, 1997.

13. J Bain: Can Fam Physician 2001 Jan;47:91-97.

Last Modified: Jan. 25, 2008