Protracted delirium with Sheehan's syndrome

Area of Science:

• Neuropsychiatry
• Endocrinology

Background:

• Delirium is a common yet frequently misdiagnosed condition.
• Variable clinical presentations and durations complicate delirium diagnosis.
• Sheehan's syndrome, a rare cause of hypopituitarism, can present with diverse symptoms.

Purpose of the Study:

• To report a case of protracted delirium secondary to an undiagnosed endocrine disorder.
• To highlight the diagnostic challenges posed by delirium in the context of severe somatic illness and psychiatric symptoms.

Main Methods:

• Case report of a patient with protracted delirium following severe somatic illness.
• Investigation revealed previously undiagnosed Sheehan's syndrome as an underlying cause.

Main Results:

• The patient presented with varied psychiatric symptoms, initially mimicking a psychotic disorder.
• The protracted course and initial presentation delayed the delirium diagnosis, leading to consideration of personality change.
• Undiagnosed Sheehan's syndrome was identified as a contributing factor to the prolonged delirium.

Conclusions:

• This case underscores the importance of considering protracted delirium in patients with persistent neuropsychiatric deficits after somatic illness.
• Early identification and management of underlying causes, such as endocrine disorders, are crucial for resolving delirium.
• Clinicians should maintain a high index of suspicion for delirium, even with atypical presentations or prolonged courses.