Journal List > J Korean Soc Endocrinol > v.21(4) > 1063878

Kim, Kim, Park, Yang, Kim, Yoo, Park, Ryu, Lee, Kim, Seo, Kim, Choi, Baik, and Choi: A Case of Sheehan's Syndrome Presenting Central Diabetes Insipidus

Abstract

Sheehan's syndrome occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage. The manifestations of this clinical syndrome are most often caused by a deficiency in the hormones produced by the anterior pituitary gland, whereas the neurohypophysis is usually preserved but can be involved in severe cases that manifest as diabetes insipidus. This is a report of Sheehan's syndrome that manifested with diabetes insipidus as presenting symptom 2 month's after delivery. The patient suffered massive bleeding, so received a blood transfusion. A combined pituitary stimulation and water deprivation test revealed deficiencies of not only anterior pituitary hormones, such as growth hormone and prolactin, but also of anti-diuretic hormone. We report this case, with a review of the literature.

Figures and Tables

Fig. 1
Sella MRI. Sagital T1 weighted image shows pituitary fossa replaced by cerebrospinal fluid and the absence of normal posterior pituitary bright spot in the posterior pituitary gland.
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Table 1
Water deprivation test with pitressin stimulation
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Table 2
Combined pituitary stimulation test
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ACTH (basal): 12.1 pg/mL, T3: 88.6 ng/dL, free T4: 0.96 ng/dL, Estradiol (E2): 19.0 pg/mL.

ACTH, adrenocorticotropic hormone; FSH, follicle stimulating hormone; LH, luteining hormone; TSH, thyroid stimulating hormone

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