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Transient pituitary insufficiency in the acute postpartum state mimicking Sheehan syndrome
(Lippincott Williams & Wilkins, 2006) Sayin, N. Cenk; Canda, M. Tunc; Ugur-Altun, Betul; Ozden, Gulsah; Yarol, Fusun G.
A 34-year-old woman was referred to our obstetrics department because of severe postpartum hemorrhage. She had undergone a cesarean delivery in another hospital earlier in the day. The patient's hemoglobin (Hb) level was 7 g/dL. Blood transfusions were begun, but the bleeding continued and an emergent total abdominal hysterectomy was performed. Postoperatively, the Hb level returned to normal by 3 days with ongoing transfusion. Her lactation could not be induced. To assess the level of pituitary damage, an insulin tolerance test was performed. Growth hormone and cortisol levels were measured. These tests revealed attenuated responses for both cortisol and growth hormone. Three months later, thyroid function tests revealed secondary hypothyroidism. However, these findings were transient. By 15 months, however, all hormonal levels were normal. We report the case as an example of spontaneous recovery from hypopituitarism caused by obstetric hemorrhage.