Laway Bashir A, Alai Mohammad S, Gojwari Tariq, Ganie Mohd A, Zargar Abdul Hamid
Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
Ann Saudi Med. 2010 Jul-Aug;30(4):321-4. doi: 10.4103/0256-4947.65269.
Cardiac abnormalities in patients with Sheehan syndrome are uncommon. A case of Sheehan syndrome with dilated cardiomyopathy is presented in whom hormone replacement with levothyroxine and prednisolone resulted in complete recovery of cardiomyopathy. A 25-year-old woman presented with lactation failure, secondary amenorrhea, features of hypothyroidism and a hypocortisol state following severe postpartum hemorrhage after her last child birth. She also had smear positive pulmonary tuberculosis. After starting antitubercular treatment, she developed shock, suggestive of hypocortisol crisis. Hormonal investigations revealed evidence of panhypopitutarism and magnetic resonance imaging revealed partial empty sella. Meanwhile echocardiography revealed evidence of dilated cardiomyopathy (DCM). The patient was given replacement therapy in the form of glucocorticoids and levothyroxine in addition to antitubercular treatment. She improved and on follow-up over a period of 7 months, the DCM completely reversed. To our knowledge this is the first report of reversible DCM in a patient with Sheehan syndrome.
席汉综合征患者出现心脏异常并不常见。本文报告一例席汉综合征合并扩张型心肌病的病例，该患者接受左甲状腺素和泼尼松龙激素替代治疗后，心肌病完全恢复。一名25岁女性，在最后一次分娩后发生严重产后出血，出现泌乳失败、继发性闭经、甲状腺功能减退和皮质醇减少状态。她还涂片阳性患有肺结核。开始抗结核治疗后，她出现休克，提示肾上腺皮质功能减退危象。激素检查显示有全垂体功能减退的证据，磁共振成像显示部分空蝶鞍。同时，超声心动图显示有扩张型心肌病（DCM）的证据。除抗结核治疗外，该患者还接受了糖皮质激素和左甲状腺素的替代治疗。她的病情有所改善，经过7个月的随访，扩张型心肌病完全逆转。据我们所知，这是首例关于席汉综合征患者可逆性扩张型心肌病的报告。
