title: Sheehan syndrome with reversible dilated cardiomyopathy.
abstract: Cardiac abnormalities in patients with Sheehan syndrome are uncommon. A case of Sheehan syndrome with dilated cardiomyopathy is presented in whom hormone replacement with levothyroxine and prednisolone resulted in complete recovery of cardiomyopathy. A 25-year-old woman presented with lactation failure, secondary amenorrhea, features of hypothyroidism and a hypocortisol state following severe postpartum hemorrhage after her last child birth. She also had smear positive pulmonary tuberculosis. After starting antitubercular treatment, she developed shock, suggestive of hypocortisol crisis. Hormonal investigations revealed evidence of panhypopitutarism and magnetic resonance imaging revealed partial empty sella. Meanwhile echocardiography revealed evidence of dilated cardiomyopathy (DCM). The patient was given replacement therapy in the form of glucocorticoids and levothyroxine in addition to antitubercular treatment. She improved and on follow-up over a period of 7 months, the DCM completely reversed. To our knowledge this is the first report of reversible DCM in a patient with Sheehan syndrome.
authors.affiliation: Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Bashir A
authors.initials: BA
authors.lastname: Laway
authors.forename: Mohammad S
authors.initials: MS
authors.lastname: Alai
authors.forename: Tariq
authors.initials: T
authors.lastname: Gojwari
authors.forename: Mohd A
authors.initials: MA
authors.lastname: Ganie
authors.forename: Abdul Hamid
authors.initials: AH
authors.lastname: Zargar
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007018:Hypopituitarism / Q000150:complications* / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use; D013974:Thyroxine / Q000627:therapeutic use; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents; D005938:Glucocorticoids; D011239:Prednisolone; D013974:Thyroxine