Sheehan's Syndrome Presenting with Hyponatraemia: A Case Report

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Prasanta Kumar Bhattacharya MBBS MD PhD FICP FACP
Aakash Roy MBBS
Md. Jamil MBBS MD
Pranjal Phukan MBBS MD DM
Kalyan Sarma MBBS

Keywords

sheehan's syndrome, hyponatraemia

Abstract

Sheehan syndrome (SS), or post partum necrosis of the pituitary gland, is a rare complication of post partum haemorrhage usually presenting with failure of lactation and subsequent amenorrhoea. We report a case of a 30-year-old woman with history of secondary amenorrhea and lactational failure following childbirth complicated with severe post partum hemorrhage, who presented to us with anemia, hypotension, acute confusion, neuropsychiatric manifestations, abnormal posturing and severe hyponatraemia. Hormonal assays revealed low pituitary hormones, subnormal levels of cortisol and thyroid hormones, with magnetic resonance imaging of the brain suggestive of SS. Hyponatraemia and late onset neuro-psychiatric manifestations are uncommon presentations of SS. Hence, there should be a high index of clinical suspicion for Sheehan’s syndrome in women with secondary amenorrhea and lactational failure following childbirth, who present with late onset neuro-psychiatric manifestations and hyponatremia.
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