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Pituitary function tests in Sheehan's syndome.

M Shahmanesh, Z Ali, M Pourmand

    Clinical Endocrinology
    |March 1, 1980
    PubMed
    Summary
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    Sheehan's syndrome patients show preserved pituitary function for LH and FSH but not prolactin or GH. Absence of a prolactin rise after TRH stimulation may indicate pituitary hypofunction post-hemorrhage.

    Area of Science:

    • Endocrinology
    • Reproductive Medicine
    • Pituitary Disorders

    Background:

    • Sheehan's syndrome, a rare condition caused by postpartum hemorrhage, leads to pituitary gland damage.
    • Assessing residual pituitary function is crucial for managing patients with Sheehan's syndrome.

    Purpose of the Study:

    • To evaluate the pituitary function in patients with Sheehan's syndrome.
    • To determine the most sensitive diagnostic marker for pituitary hypofunction in this cohort.

    Main Methods:

    • Fourteen patients with Sheehan's syndrome underwent pituitary stimulation tests.
    • Tests included injections of Luteinizing Hormone-Releasing Hormone (LH-RH), Thyrotropin-Releasing Hormone (TRH), and insulin-induced hypoglycemia.
    • Serum levels of LH, FSH, TSH, prolactin, and Growth Hormone (GH) were measured.

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    Main Results:

    • Significant rises in Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH) were observed in most patients after LH-RH stimulation.
    • Thyroid-Stimulating Hormone (TSH) levels rose in some patients after TRH stimulation.
    • Prolactin levels did not change after TRH, and GH levels failed to rise after hypoglycemia in several subjects.

    Conclusions:

    • Pituitary function for LH and FSH is relatively preserved in Sheehan's syndrome.
    • Prolactin and GH secretion are often impaired.
    • Lack of prolactin response to TRH may be a sensitive indicator of pituitary hypofunction following postpartum hemorrhage.