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Case report: interferon induced coma in Sheehan's syndrome

K Mabe1, H Shinzawa, K Yamatani

  • 1Second Department of Internal Medicine, Yamagata University School of Medicine, Japan.

Journal of Gastroenterology and Hepatology
|July 1, 1997
PubMed
Summary

Interferon therapy for hepatitis C can unmask Sheehan's syndrome, a pituitary disorder. Prompt electrolyte and hormone replacement therapy led to a full recovery in this patient.

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Area of Science:

  • Endocrinology
  • Hepatology
  • Internal Medicine

Background:

  • Hepatitis C is a significant global health concern.
  • Interferon (IFN)-alpha therapy has been used for chronic active hepatitis C.
  • Sheehan's syndrome is a rare condition of hypopituitarism caused by postpartum hemorrhage.

Observation:

  • A 54-year-old woman on IFN-alpha developed coma and severe electrolyte imbalances (hyponatremia, hypochloremia).
  • She had a history of postpartum hemorrhage and amenorrhea.

Findings:

  • Endocrinological tests revealed anterior pituitary hypofunction.
  • The patient's condition improved with electrolyte and hormone replacement (hydrocortisone, l-thyroxine).
  • Interferon therapy precipitated the overt manifestation of Sheehan's syndrome.

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Implications:

  • Hepatitis C treatment may reveal underlying pituitary insufficiency.
  • Careful monitoring for endocrine dysfunction is crucial in patients receiving interferon therapy.
  • Early diagnosis and treatment of Sheehan's syndrome are vital for patient recovery.