Practice of symptomatic treatment in the era of evidence-based medicine: report of 2 cases of diagnosis of Sheehan's syndrome delayed till eighth decade.
Sheehan's syndrome, first described in 1937, is characterised by postpartum haemorrhage, pituitary necrosis, lactational failure and hypopitutarism. Presentation is variable and late presentations are not unusual due to partial ischaemic injury of the pituitary and gradual loss of endocrine function. A history of postpartum haemorrhage is usual but in some cases it is not elicited. Presentations such as malaise, fatigue, hypoglycaemia, decline in cognition, hyponatraemia, pancytopoenia, osteoporosis, secondary infertility, confusion and coma have all been reported. Two interesting cases of Sheehan's syndrome are presented that were diagnosed in the eighth decade; one due to atypical presentation of recurrent hyponatraemia and confusion, another from hypoglycaemic coma and symptoms of malaise and lethargy.
Hera General Hospital, Makkah, Saudi Arabia. dr_wani_majid@yahoo.co.in
Abdul Majid
AM
Wani
Waleed Mohd
WM
Hussain
Mousa Ali
MA
Al Mejally
Abdulhakeem Amroon
AA
Banjar
Khaled Shawkat
KS
Ali
Amer Mohd
AM
Khoujah
Sadeya Hanif
SH
Raja
Mazen G
MG
Bafaraj
Wail
W
Al Miamini
Mubeena
M
Akhtar
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D013974:Thyroxine / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D013974:Thyroxine