Endocrine Abstracts

Introduction: Sheehan Syndrome (SS) is the oldest known cause of non-tumor acquired anterior pituitary insufficiency in women. The incidence of SS would probably have decreased in recent decades in developed countries thanks to the development of obstetric care. However, it still remains a public health problem in developing countries. In addition, it constitutes a chronic disabling pathology and is strongly linked to an alteration of the quality of life. In this study we aimed to evaluate the impact on quality of life of SS.

Patients and methods: This is a descriptive cross-sectional study. It was carried out in the Endocrinology department of the University Hospital Farhat Hached, Sousse, Tunisia, over a period of nine months, from July 2019 to March 2020. The assessment of quality of life was based on the specific questionnaire “Quality of Life Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA)”. It is composed of 25 items. The answer choice of the 25 “yes/no” items is scored 1/0. The total score is calculated as the sum of the item scores, ranging from 0 to 25, with a higher score indicating a lower quality of life.

Results: Sixty five patients were included to the study. The mean age at diagnosis of SS was 48.2 ± 12.4 years. Thyrotropic and corticotropic insufficiency were present in 86.2% of our patients, followed by gonadotropic and lactotroph insufficiency in 72.3% and 38.5% of patients, respectively. Somatotropic insufficiency was explored by a dynamic test in only 8 patients, concluding with somatotropic deficiency in 10.8% of cases. Quality of life was assessed in 15 patients, with a mean QoL-AGHDA quality of life questionnaire score of 12.8 ± 5.5. Eight patients had a total score of the QoL-AGHDA questionnaire greater than or equal to 11. Seven patients, including three with a total QoL-AGHDA quality of life score of more than 18, were followed for an anxiety-depressive disorder. A 66-year-old patient presented cognitive disorders such as memory and concentration disorders after 26 years of evolution of SS. We did not note any significant correlation between the quality of life score and the SS dependent factors (duration of the SS, the existence or not of corticotropic or gonadotropic insufficiency, the dose of hydrocortisone\..).

Discussion-Conclusion: SS is a chronic disease strongly associated with impaired quality of life, mainly due to GH deficiency and glucocorticoid overdose.