Spontaneous pregnancy and partial recovery of pituitary function in a patient with Sheehan's syndrome.
Sheehan's syndrome is caused by pregnancy-related hemorrhage leading to ischemic necrosis of the anterior pituitary gland and hypopituitarism. Spontaneous pregnancy in Sheehan's syndrome is very rare. We report the case of a patient with Sheehan's syndrome who suffered from anterior pituitary insufficiency, but with sparing of gonadotropic function. The patient became pregnant spontaneously and, after her second delivery, thyrotropic function recovered. However, the patient's growth hormone and cortisol levels remained unresponsive to an insulin-tolerance test. This case demonstrates that pituitary function may recover from less extensive pituitary ischemia. We emphasize the importance of early identification of pregnancy in such cases. It is crucial to institute adequate hormone-replacement therapy during pregnancy, since hypopituitarism is associated with high fetal and maternal morbidity and mortality.
See
Ting-Ting
TT
Section of Endocrinology and Metabolism, Department of Internal Medicine, Far Eastern Memorial Hospital, Panchiao, Taipei, Taiwan, ROC.
Lee
Siu-Pak
SP
Chen
Hua-Fen
HF
D000309:Adrenal Insufficiency / Q000209:etiology; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D013006:Growth Hormone / Q000097:blood / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism; D007003:Hypoglycemia / Q000209:etiology; D007006:Hypogonadism / Q000209:etiology; D007018:Hypopituitarism / Q000150:complications*; D007019:Hypoproteinemia / Q000209:etiology; D007037:Hypothyroidism / Q000209:etiology; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D010901:Pituitary Function Tests; D011247:Pregnancy
D001786:Blood Glucose; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D006854:Hydrocortisone