Unusual presentation of Sheehan’s Syndrome with recurrent episodes of hypoglycemia, 8 Years Postpartum: A Case Report

Salmani Izadi, Hanieh; Hasani, Solmaz

doi:10.61186/JBUMS.31.3.249

Volume 31, Issue 3 (November 2024) J Birjand Univ Med Sci. 2024, 31(3): 249-255 | Back to browse issues page

‎ 10.61186/JBUMS.31.3.249

Research code: IR.MUMS.REC.1403.127

Ethics code: IR.MUMS.REC.1403.127

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Salmani Izadi H, Hasani S. Unusual presentation of Sheehan’s Syndrome with recurrent episodes of hypoglycemia, 8 Years Postpartum: A Case Report. J Birjand Univ Med Sci. 2024; 31 (3) :249-255
URL: http://journal.bums.ac.ir/article-1-3418-en.html

Unusual presentation of Sheehan’s Syndrome with recurrent episodes of hypoglycemia, 8 Years Postpartum: A Case Report

Hanieh Salmani Izadi¹

, Solmaz Hasani ^*²

1- Department of Internal Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2- Endocrine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran , HasaniS@mums.ac.ir

Abstract: (764 Views)

Sheehan syndrome, also known as postpartum hypopituitarism, is a very serious complication of postpartum hemorrhage. It usually remains underdiagnosed years after delivery as symptoms may be subtle, especially in developing countries due to poor obstetric care and home deliveries. This case report highlights the importance of recognizing atypical presentations, such as hypoglycemic attacks, to help with early diagnosis and better management.
A female 34-year-old, G4P2Ab2L2, presented with a low level of consciousness, diaphoresis, and severe hypoglycemia after C-section delivery. Adetailed history revealed a history of failure of lactation following her first vaginal delivery, 8 years ago, accompanied by no complication or history of postpartum hemorrhage. She has experienced a few episodes of hypotension, malaise, and hypoglycemia afterward. Laboratory examination displayed adenohypophyseal insufficiency as evident from low blood glucose level in the presence of low levels of cortisol, Adrenocorticotropic hormone (ACTH), and prolactin. Sheehan syndrome was confirmed with Magnetic resonance imaging (MRI) of the pituitary as an empty sella turcica consistent with the provisional diagnosis. This case report emphasizes the significance of early suspicion in cases presented with less known complications of Sheehan's syndrome as recurrent symptomatic episodes of hypoglycemia and management of this easily missed and treatable condition.

Keywords: Case report, Hypoglycemia, Pregnancy, Secondary adrenal insufficiency, Sheehan’s syndrome

Full-Text [PDF 381 kb] (318 Downloads) | | Full-Text (HTML) (153 Views)

Type of Study: Case Report | Subject: Endocrinology
Received: 2024/05/10 | Accepted: 2024/08/17 | ePublished ahead of print: 2024/09/25 | ePublished: 2024/12/5

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