Sert Murat, Tetiker Tamer, Kirim Sinan, Kocak Mustafa
Cukurova University, Medical Faculty, Department of Internal Medicine, Endocrinology Division, Balcali Hospital, 01330 Adana, Turkey.
Endocr J. 2003 Jun;50(3):297-301. doi: 10.1507/endocrj.50.297.
The aim of the present study was to determine the clinical and hormonal characteristics with Sheehan's syndrome in 28 cases that we had diagnosed and followed in the last 20 years. Twenty-eight patients with Sheehan's syndrome, diagnosed and followed at our University Endocrinology Clinic in the last 20 years were reported in the study. Medical history, physical examination, routine laboratory examinations, pituitary hormone analysis, CT and/or MRI scan of the sella of the patients were reviewed. All patients had a history of massive hemorrhage at delivery and physical signs of Sheehan's syndrome. Twenty-six of them lacked postpartum milk production, followed by failure of resumption of menses. There were 9 subjects with disturbances in consciousness associated with hyponatremia on admittance. All 28 patients had secondary hypothyroidism, adrenal cortex failure, hypogonadotrophic hypogonadism and growth hormone deficiency. Diabetes insipidus has not been found in any patient. Empty sellae were revealed in 8 patients by CT and/or MRI scan. Sheehan's syndrome is still encountered in clinical practice occasionally. If not diagnosed early, it could cause increased morbidity and mortality. The most important clues for diagnosis of Sheehan's syndrome are lack of lactation and failure of menstrual resumption after a delivery complicated with severe hemorrhage.
本研究的目的是确定我们在过去20年中诊断并随访的28例席汉综合征患者的临床和激素特征。该研究报告了过去20年在我们大学内分泌诊所诊断并随访的28例席汉综合征患者。回顾了患者的病史、体格检查、常规实验室检查、垂体激素分析、蝶鞍的CT和/或MRI扫描结果。所有患者均有分娩时大出血史及席汉综合征的体征。其中26例产后无乳汁分泌，随后月经未恢复。9例患者入院时伴有意识障碍及低钠血症。28例患者均有继发性甲状腺功能减退、肾上腺皮质功能减退、低促性腺激素性性腺功能减退和生长激素缺乏。所有患者均未发现尿崩症。8例患者经CT和/或MRI扫描显示为空蝶鞍。席汉综合征在临床实践中仍偶尔可见。若不及早诊断，可导致发病率和死亡率增加。诊断席汉综合征最重要的线索是产后严重出血后无乳汁分泌及月经未恢复。
