López de la Torre Casares M, Gargallo Fernández M, Moreno Esteban B, Rodríguez Arnao M D, Jara Albarrán A, Rodríguez Poyo-Guerrero P
Servicio de Endocrinología, Hospital General Gregorio Marañón, Madrid.
Med Clin (Barc). 1990 Jun 2;95(1):1-4.
We evaluated six patients in whom a diagnosis of Sheehan's syndrome had been made. The plasma levels of the following hormones were measured: basal thyroxine (T4), estradiol and cortisol; and also follicle-stimulating hormone (FSH), luteinizing hormone (LH), growth hormone (GH), thyrotropin (TSH), prolactin (PRL) and adrenocorticotropic hormone (ACTH), basally and after acute challenge with LH releasing hormone (LHRH), GRF (1-29)NH2 or insulin hypoglycemia, TSH releasing hormone (TRH) and lysine-8-vasopressin, respectively. Two patients underwent chronic LHRH stimulation by pulsatile subcutaneous administration with infusion pump. In 4 cases, computed tomography (CT) was performed although cranial X-ray study was normal. A severe and generalized pituitary involvement was found in all patients, 3 of whom had diabetes mellitus. Probably, more insidious cases go unnoticed. The presence of asymptomatic partial empty sella (ES) in all the CTs that were carried out raises the possibility that it is another evolutive feature of SS.
我们评估了6例已确诊为席汉综合征的患者。检测了以下激素的血浆水平：基础甲状腺素（T4）、雌二醇和皮质醇；还检测了基础状态下以及分别用促黄体生成素释放激素（LHRH）、生长激素释放因子（GRF [1-29]NH2）或胰岛素低血糖、促甲状腺激素释放激素（TRH）和赖氨酸-8-加压素进行急性激发后，促卵泡生成素（FSH）、促黄体生成素（LH）、生长激素（GH）、促甲状腺激素（TSH）、催乳素（PRL）和促肾上腺皮质激素（ACTH）的水平。2例患者通过输液泵皮下脉冲给药进行慢性LHRH刺激。4例患者尽管头颅X线检查正常，但仍进行了计算机断层扫描（CT）。所有患者均发现严重且广泛的垂体受累，其中3例患有糖尿病。可能有更多隐匿性病例未被发现。所有进行的CT检查中均存在无症状性部分空蝶鞍（ES），这增加了其是席汉综合征另一种演变特征的可能性。
