An uncommon cause of anaemia: Sheehan's syndrome.
Ischemic pituitary necrosis due to severe postpartum haemorrhage called Sheehan's syndrome is a rare cause of hypopituitarism in the western world, but much more common in developing countries. A 45-year-old female patient being a war refugee from Chechnya with severe anaemia and fatigue was diagnosed at our outpatient department with Sheehan's syndrome after severe postpartum haemorrhage and emergency hysterectomy 15 years ago. Panhypopituitarism was adequately treated with substitution of hydrocortisone, thyroxine and transdermal oestrogen which resulted in haemoglobin increase to nearly normal levels and symptoms improved immediately. Severe anaemia caused by panhypopituitarism shows the importance of the hormonal system for erythropoiesis. Clinical and basic scientific evidence indicates thyroidal hormones to be the main cause.
IIIrd Medical Department with Haematology, Medical Oncology, Haemostaseology, Rheumatology, Infectious Disease of the Private Medical University Hospital Laboratory for Immunological and Molecular Cancer Research, Salzburg, Austria. t.melchardt@salk.at
Thomas
T
Melchardt
Konrad
K
Namberger
Lukas
L
Weiss
Alexander
A
Egle
Viktoria
V
Faber
Richard
R
Greil
D000740:Anemia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D016896:Treatment Outcome