Clinical and paraclinical characteristics of women with sheehan

Salma Salhi; Ibtissem Oueslati; Cyrine Chehaider; Anis Grassa; Amani Terzi; Fatma Chaker; Meriem Yazidi; Melika Chihaoui

doi:10.1530/endoabs.99.EP93

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Endocrine Abstracts (2024) 99 EP93 | DOI: 10.1530/endoabs.99.EP93

ECE2024 Eposter Presentations Pituitary and Neuroendocrinology (214 abstracts)

Clinical and paraclinical characteristics of women with sheehan’s syndrome

Salma Salhi ¹ , Ibtissem Oueslati ¹ , Cyrine Chehaider ¹ , Anis Grassa ¹ , Amani Terzi ¹ , Fatma Chaker ¹ , Meriem Yazidi ¹ & Melika Chihaoui ¹

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¹La Rabta University Hospital, Department of Endocrinology, Tunis, Tunisia

Introduction: Sheehan’s syndrome is a rare cause of hypopituitarism. It is defined by an ischemic necrosis of the pituitary gland following postpartum hemorrhage. Sheehan syndrome is characterized by various endocrine deficiencies. The aim of the present study was to determine the clinical and paraclinical characteristics of women with Sheehan syndrome.

Methods: This was a monocentric cross-sectional study including 50 women followed for Sheehan’s syndrome in the Department of Endocrinology of La Rabta University Hospital of Tunis. Clinical and paraclinical data were collected.

Results: The mean age of participants was 62.2±9.4 years. Diagnostic delay of SS was 11.1±9.4 years [Range: 0-37 years]. The mean duration of the disease was 31.6±9.9 years. Postpartum hemorrhage occurred in all patients, with 12% of them required hysterectomy. The disease was revealed by acute adrenal insufficiency in 86% of patients, secondary amenorrhea in 10%, and secondary hypothyroidism in 4% of cases. Laboratory investigations revealed complete anterior pituitary deficiency in all patients with no case of central diabetes insipidus. Magnetic resonance imaging showed empty sella turcica in all cases. The mean hydrocortisone dose was 20.30±2.75 mg/day. A daily dose >20 mg was prescribed in 10% of cases. The mean levothyroxine dose was 1.60±0.54 μg/kg/day. Only 21 women (42%) received estrogen-progesterone therapy. GH treatment was not prescribed in all participants.

Conclusions: Women with Sheehan syndrome have important exposure to hormonal deficiencies due to the long diagnostic delay, which make them at higher risk of complications compared to other pituitary deficient patients.