Sheehan syndrome
12,313views
00:00 / 00:00
Videos
Notes
Sheehan syndrome
Pathology
Adrenal gland disorders
Congenital adrenal hyperplasia
Primary adrenal insufficiency
Waterhouse-Friderichsen syndrome
Hyperaldosteronism
Adrenal cortical carcinoma
Cushing syndrome
Conn syndrome
Thyroid gland disorders
Thyroglossal duct cyst
Hyperthyroidism
Graves disease
Thyroid eye disease (NORD)
Toxic multinodular goiter
Thyroid storm
Hypothyroidism
Euthyroid sick syndrome
Hashimoto thyroiditis
Subacute granulomatous thyroiditis
Riedel thyroiditis
Postpartum thyroiditis
Thyroid cancer
Parathyroid gland disorders
Hyperparathyroidism
Hypoparathyroidism
Hypercalcemia
Hypocalcemia
Pancreatic disorders
Diabetes mellitus
Diabetic retinopathy
Diabetic nephropathy
Pituitary gland disorders
Hyperpituitarism
Pituitary adenoma
Hyperprolactinemia
Prolactinoma
Gigantism
Acromegaly
Hypopituitarism
Growth hormone deficiency
Pituitary apoplexy
Sheehan syndrome
Hypoprolactinemia
Constitutional growth delay
Diabetes insipidus
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Gonadal dysfunction
Precocious puberty
Delayed puberty
Premature ovarian failure
Polycystic ovary syndrome
Androgen insensitivity syndrome
Kallmann syndrome
5-alpha-reductase deficiency
Polyglandular syndromes
Autoimmune polyglandular syndrome type 1 (NORD)
Endocrine tumors
Multiple endocrine neoplasia
Pancreatic neuroendocrine neoplasms
Zollinger-Ellison syndrome
Carcinoid syndrome
Pheochromocytoma
Neuroblastoma
Opsoclonus myoclonus syndrome (NORD)
Endocrine system pathology review
Adrenal insufficiency: Pathology review
Adrenal masses: Pathology review
Hyperthyroidism: Pathology review
Hypothyroidism: Pathology review
Thyroid nodules and thyroid cancer: Pathology review
Parathyroid disorders and calcium imbalance: Pathology review
Diabetes mellitus: Pathology review
Cushing syndrome and Cushing disease: Pathology review
Pituitary tumors: Pathology review
Hypopituitarism: Pathology review
Diabetes insipidus and SIADH: Pathology review
Multiple endocrine neoplasia: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
Assessments
Sheehan syndrome
Flashcards
0 / 8 complete
USMLE® Step 1 questions
0 / 3 complete
High Yield Notes
13 pages
Flashcards
Sheehan syndrome
of complete
Questions
USMLE® Step 1 style questions USMLE
of complete
Memory Anchors and Partner Content
External References
First Aid
2022
2021
2020
2019
2018
2017
2016
Childbirth
Sheehan syndrome after p. 351
Lactation p. 654
Sheehan syndrome and p. 351
Sheehan syndrome p. 345, 664
External Links
Transcript
Content Reviewers
Rishi Desai, MD, MPHSheehan’s syndrome, is also sometimes called postpartum pituitary gland necrosis, and we can break that down.
Postpartum refers to the time after a mother gives birth to an infant, pituitary gland refers to a tiny gland that is at the base of the brain, and necrosis refers to death.
So, postpartum pituitary gland necrosis is a disorder where cells in a pituitary gland of a new mother start to die - most commonly because excess blood loss during childbirth leaves those cells without adequate blood flow. It is a rare type of pituitary apoplexy.
During pregnancy, a group of cells in the pituitary gland called lactotrophs start to increase in size and number.
These lactotrophs secrete the hormone prolactin, and the increased levels of prolactin prepares the mammary glands to produce milk.
Even though there are more lactotrophs that are larger and more metabolically active, the blood supply to the pituitary gland remains the same.
So there is an increased demand without an increase in supply, means the lactotrophs are hypoperfused.
In other words, the lactotrophs are just barely getting by, and if they get any less blood, than they face ischemic injury and necrosis or death.
What’s even more alarming is that since there are more metabolically active lactotrophs around, they take up a larger proportion of the blood that supplies the pituitary, increasing the risk of ischemia in other cells of the pituitary gland as well.
During the delivery of an infant, excessive blood loss is called postpartum hemorrhage.
Postpartum hemorrhage is generally defined as losing more than 500ml of blood after a vaginal delivery or more than 1000ml after a cesarean section delivery.
Summary
Sheehan syndrome, also known as postpartum hypopituitarism, is a condition that affects women who have experienced postpartum hemorrhage (PPH). PPH causes ischemia to lactotrophs and other cells of the pituitary, causing them. This results in deficiencies of prolactin, growth hormone, thyroid stimulating hormone, adrenocorticotropic hormone, luteinizing hormone, and follicle-stimulating hormone.
During pregnancy, pituitary cells increase in size and number, taking up more blood than usual. So, when there is PPH, these cells are prone to starve and become ischemic. An early symptom of Sheehan syndrome is agalactorrhea, whereas late symptoms include amenorrhea, low blood pressure, low blood sodium, and glucose levels, fatigue, and muscle loss. Sheehan's syndrome can be treated by replacing the deficient hormones, usually for a person's entire life.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw Hill Professional (2019)
- "Harrison's Endocrinology, 4E" McGraw Hill Professional (2016)
- "Sheehan′s syndrome: Newer advances" Indian Journal of Endocrinology and Metabolism (2011)
- "Hypopituitarism After Traumatic Brain Injury" Cureus (2019)
- "Advances in understanding hypopituitarism" F1000Research (2017)
Copyright © 2023 Elsevier, except certain content provided by third parties
Cookies are used by this site.
USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.
