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Pituitary function in Sheehan's syndrome.

I Jialal, C Naidoo, R J Norman

    Obstetrics and Gynecology
    |January 1, 1984
    PubMed
    Summary
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    Sheehan's syndrome impairs pituitary hormone release. Measuring prolactin response to thyrotropin-releasing hormone (TRH) offers a reliable screening method for this condition.

    Area of Science:

    • Endocrinology
    • Reproductive Medicine
    • Pituitary Disorders

    Background:

    • Sheehan's syndrome is a rare but serious condition affecting the pituitary gland.
    • Assessing pituitary function in Sheehan's syndrome requires evaluating multiple hormone axes.
    • Standard diagnostic tests can be complex and time-consuming.

    Purpose of the Study:

    • To evaluate pituitary hormone responses in women with Sheehan's syndrome.
    • To determine the reliability of prolactin response to TRH as a diagnostic marker.
    • To assess the adequacy of growth hormone, cortisol, FSH, and LH secretion.

    Main Methods:

    • Ten women with Sheehan's syndrome underwent testing.
    • Intravenous administration of releasing hormones (TRH, GnRH) was performed.

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  • Measurements included plasma prolactin, FSH, LH, TSH, growth hormone, and cortisol.
  • Insulin-induced hypoglycemia was used to assess GH and cortisol response.

    • Main Results:

    • Eight patients were hypothyroid despite normal TSH in some cases.
    • All patients showed inadequate growth hormone response to hypoglycemia.
    • Only one patient had a normal cortisol response to hypoglycemia.
    • Prolactin levels did not reach reference ranges after TRH administration in any patient.
    • LH and FSH responses to GnRH were adequate in most patients.

    Conclusions:

    • Standard TSH levels may not accurately reflect thyroid status in Sheehan's syndrome.
    • Growth hormone and cortisol deficiencies are common.
    • Prolactin response to TRH is a potentially simple and reliable screening test for Sheehan's syndrome.
    • Further investigation of pituitary axes is crucial for comprehensive diagnosis.