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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
Case Report
Journal of Korean Society of Endocrinology

Journal of Korean Society of Endocrinology 2006; 21(4): 333-337.

Published online: 20 August 2006

DOI: https://doi.org/10.3803/jkes.2006.21.4.333

A Case of Sheehan's Syndrome Presenting Central Diabetes Insipidus

Dong Jin Kim, Nan Hee Kim, Ju Ri Park, Sae Jeong Yang, Hye Suk Kim, Hye Jin Yoo, Soo Yeon Park, Ohk Hyun Ryu, Kye Won Lee, Hee Young Kim, Ji A Seo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi

Department of Internal Medicine, Korea University College of Medicine, Korea.

Received 3 February 2006       Accepted 27 March 2006

Copyright © 2006 Korean Endocrine Society

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.

Keywords: Central diabetes insipidus, Hypopituitarism, Postpartum hemorrhage, Sheehan's syndrome

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
jkse-21-333-i001
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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