Endocrine Abstracts

Introduction: Sheehan Syndrome can be determined as partial or complete hypopituitarism occurring after massive postpartum uterine hemorrhage leading to pituitary infarction. The first symptom classically described is the absence of milk flow. It is a rare and lethal condition, especially in underprivileged countries around the world. The resulting hypothyroidism is often diagnosed late, involving long-term complications. The aim of this study is to determine the prevalence of thyrotropic insufficiency associated with Sheehan Syndrome.

Methods: This is a retrospective descriptive study, including 5 patients with Sheehan Syndrome involving thyrotropic insufficiency, hospitalized in the Department of Endocrinology, diabetology and nutrition at the University Hospital of Oujda-Morocco during the period of October 2015 to December 2023. Data were analyzed by SPSS V 21.

Results-Discussion: The average age was 41.6±15.14 years with an average diagnosis time of 11.5 years. Delivery hemorrhage was observed in 3 patients (60%), while the absence of milk flow was observed in 2 patients (40%). The clinical signs were dominated by secondary amenorrhea in 60% of cases. All patients expressed signs of hypothyroidism. The TSHus varied between 0.17 mIU/l and 2.88 mIU/l, and FT4 was low in all cases, with an average of 4.28 pmol±4.56 pmol/l. Hypothalamic-pituitary MRI imaging was in favor of an arachnoidocele in all our patients. All patients were treated with levothyroxine with good clinical improvement.

Conclusion: Thyroid insufficiency is one of the most important endocrine disorders, due to its cardiovascular risk. Furthermore, in the presence of massive post-partum haemorrhage, strict surveillance is required to early detection of Sheehan syndrome.