title: Sheehan's syndrome in Xinjiang: Clinical characteristics and laboratory evaluation of 97 patients.
abstract: OBJECTIVE
  To evaluate the clinical and hormonal characteristics of patients with Sheehan's syndrome in Xinjiang, China.
  
  
  METHODS
  97 cases diagnosed as Sheehan's syndrome in our hospital from 1999 to 2013 were retrospectively reviewed. The medical history, physical examination findings and hormonal profiles were documented and analyzed.
  
  
  RESULTS
  The mean age at diagnosis was 43.7±12.4 years, with a mean diagnostic delay of 9.1±9.5 years (range, 1 month-35 years). 10 of our patients (10.3%) had a home birth. 96 of our patients (99.0%) had a history of obstetric hemorrhage. The most common clinical presentation included amenorrhea (80/97, 82.5%), agalactia (2/97, 74.2%) and loss of axillary or pubic hair (83/97, 85.6%). Seventy two of our patients (74.2%) failed to lactate and 80 of our patients (82.5%) failed to resume menstruation. Hypothalamic dysfunction included the hypothalamic-pituitary-gonadal axis (HPG) (LH deficiency: 77/83 patients, 92.8%; FSH deficiency: 73/83 patients, 88%; E2 deficiency: 62 of 82 patients,75.6%), the hypothalamic-pituitary-thyroid (HPT) axis (TSH deficiency: 77/93 patients, 82.8%, TT3 deficiency: 70/ 87 patients, 80.5%, TT4 deficiency: 72/87 patients, 82.8%) and the hypothalamus-pituitary-adrenal (HPA) axis (ACTH deficiency: 19/37 patients, 51.4%, cortisol deficiency: 49/64, 76.6%).
  
  
  CONCLUSIONS
  Sheehan's syndrome is still common in Xinjiang, especially in rural areas. Long diagnosis delay in most of the patients indicates that women might be lacking correct diagnosis and treatment. Physicians need to be aware of the most important clues for diagnosis such as lack of lactation in the postpartum period and failure to resume menstruation.
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Guo-li
authors.initials: GL
authors.lastname: Du
authors.affiliation: Department of Endocrinology, the Eastern Section of Linyi People's Hospital, Linyi, China.
authors.forename: Zhong-hua
authors.initials: ZH
authors.lastname: Liu
authors.affiliation: Department of Rehabilitation Medicine, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China.
authors.forename: Min
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Ma
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Jiang
authors.affiliation: Department of MRI, First Affiliated Hospital of Xinjiang Medical University, Urumqi; China.
authors.forename: Miriguli
authors.initials: M
authors.lastname: Shayiti
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Aibibai
authors.initials: A
authors.lastname: Yusufu
mesh_terms: D000328:Adult; D000368:Aged; D000568:Amenorrhea / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D002681:China / Q000453:epidemiology; D057210:Delayed Diagnosis; D005260:Female; D006728:Hormones / Q000097:blood*; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D007018:Hypopituitarism / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D007774:Lactation; D007775:Lactation Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D008598:Menstruation; D008875:Middle Aged; D006473:Postpartum Hemorrhage / Q000175:diagnosis / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006728:Hormones