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Recurrent hypoglycaemia: a delayed presentation of Sheehan syndrome
Naresh Kumar1, Pratap Singh2, Jyoti Kumar3
1Department of Medicine, Maulana Azad Medical College, New Delhi, India.
BMJ Case Reports
|May 21, 2014
Summary
Sheehan syndrome, a rare complication of postpartum hemorrhage, can cause delayed diagnosis due to subtle symptoms. This case highlights severe hypoglycemia as a presenting sign in a 45-year-old woman.
Area of Science:
- Endocrinology
- Neurology
Background:
- Sheehan syndrome is a rare but serious complication of severe postpartum hemorrhage.
- It often presents with delayed diagnosis due to subtle and varied symptoms.
Observation:
- A 45-year-old woman presented with acute altered sensorium and severe hypoglycemia.
- She had a 15-year history of agalactia and amenorrhea following a complicated pregnancy with excessive postpartum bleeding.
Findings:
- Brain MRI revealed an empty sella.
- Hormonal evaluation indicated adenohypophyseal insufficiency, with low cortisol, TSH, T3, free T4, FSH, LH, and prolactin levels.
Implications:
- This case underscores the importance of considering Sheehan syndrome in adult women presenting with unexplained hypoglycemia and hypopituitarism.
- Early diagnosis and hormone replacement therapy are crucial for managing Sheehan syndrome and preventing life-threatening complications.