Sheehan's syndrome
Sheehan syndrome
Classification & external resources
| ICD-10 |
E23.0 |
| ICD-9 |
253.2 |
| DiseasesDB |
11998 |
| MedlinePlus |
001175 |
| eMedicine |
med/1914 |
| MeSH |
D007018 |
Sheehan syndrome, also known as postpartum hypopituitarism or postpartum pituitary necrosis, is hypopituitarism (decreased functioning of the pituitary gland), caused by necrosis due to blood loss and hypovolemic shock during and after childbirth.
Causes
It is a rare complication of pregnancy, usually occurring after excessive blood loss; the presence of disseminated intravascular coagulation (e. in amniotic fluid embolism or HELLP syndrome) also appears to be a factor in its development.
Pathophysiology
Hypertrophy and hyperplasia of lactotrophs during pregnancy results in the enlargement of the anterior pituitary, without a corresponding increase in blood supply.
Secondly, the anterior pituitary is supplied by a low pressure portal venous system.
These vulnerabilities, when affected by major hemorrhage or hypotension during the peripartum period, can result in ischaemia of the affected pituitary regions leading to necrosis.
The posterior pituitary is usually not affected due to its direct arterial supply.
Eponym
It is named for Harold Sheehan.[1][2]
References
- ^ synd/2009 at Who Named It
- ^ H. L. Sheehan. Post-partum necrosis of anterior pituitary. The Journal of Pathology and Bacteriology, Chichester, 1937, 45: 189-214.
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Endocrine pathology: endocrine diseases (E00-35, 240-259) |
| Thyroid |
Hypothyroidism (Iodine deficiency, Cretinism, Congenital hypothyroidism, Goitre, Myxedema) - Hyperthyroidism (Graves disease, Toxic multinodular goitre, Teratoma with thyroid tissue or Struma ovarii) - Thyroiditis (De Quervain's thyroiditis, Hashimoto's thyroiditis, Riedel's thyroiditis) - Euthyroid sick syndrome |
| Pancreas |
Diabetes mellitus (type 1, type 2, coma, angiopathy, ketoacidosis, nephropathy, neuropathy, retinopathy) - Hypoglycemia - Hyperinsulinism - Zollinger-Ellison syndrome |
| Parathyroid |
Hypoparathyroidism (Pseudohypoparathyroidism) - Hyperparathyroidism (Primary, Secondary, Tertiary) |
| Pituitary |
Hyperpituitarism (Acromegaly, Hyperprolactinaemia, SIADH) - Hypopituitarism (Simmonds' disease/Sheehan's syndrome, Kallmann syndrome, Growth hormone deficiency, Diabetes insipidus) - Adiposogenital dystrophy - Empty sella syndrome |
| Adrenal |
Cushing's syndrome (Nelson's syndrome, Pseudo-Cushing's syndrome) - CAH (due to 21-hydroxylase deficiency) - Hyperaldosteronism (Conn syndrome, Bartter syndrome) - Adrenal insufficiency (Addison's disease) - Hypoaldosteronism |
| Gonads |
ovarian dysfunction (Polycystic ovary syndrome, Premature ovarian failure) - testicular dysfunction (5-alpha-reductase deficiency) - general (Hypogonadism, Delayed puberty, Precocious puberty) |
| Other |
Autoimmune polyendocrine syndrome - Carcinoid syndrome - Short stature (Laron syndrome, Psychogenic dwarfism) - Gigantism - Androgen insensitivity syndrome - Progeria - Multiple endocrine neoplasia (1, 2) |
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