Rabee' Hadi, Tanbour Raghad, Yaseen Ahmad, Zaidan Mohammed, Amer Riad
Department of Internal Medicine, An-Najah National University Hospital, Nablus, Palestinian Territory, occupied.
Istishari Arab Hospital, Ramallah, Palestinian Territory, occupied.
SAGE Open Med Case Rep. 2022 Jul 4;10:2050313X221109431. doi: 10.1177/2050313X221109431. eCollection 2022.
Sheehan's syndrome is a postpartum hypopituitarism state caused by necrosis of the pituitary gland. It is usually the result of severe hypotension or shock caused by massive hemorrhage during or after delivery. Sheehan's syndrome symptoms are often subtle and hence it is diagnosed late. Herein, we report a case of a 41-year-old woman who developed severe postpartum hemorrhage after childbirth that required a total abdominal hysterectomy to control bleeding at the age of 36 years. Since then, she has progressively developed symptoms of headache, general fatigue, and malaise, and finally presented with pancytopenia for investigations. Anemia is a well-known hematological association with Sheehan's syndrome while pancytopenia is rarely reported. However, complete recovery of pancytopenia was observed after the treatment. Pancytopenia (due to bone marrow failure to produce cells) is a serious finding in clinical practice that causes significant stress as it may point to a diagnosis of malignancy (mainly leukemia) and other serious disorders. Despite being a rare cause, a high index of suspicion is required from the physicians in women with pancytopenia, in order to look for a possible treatable cause of pancytopenia (like Sheehan's syndrome), if the common causes were excluded.
席汉综合征是一种由垂体坏死引起的产后垂体功能减退状态。它通常是分娩期间或之后大量出血导致严重低血压或休克的结果。席汉综合征的症状往往不明显，因此诊断较晚。在此，我们报告一例41岁女性病例，该患者36岁分娩后发生严重产后出血，需要行全腹子宫切除术以控制出血。从那时起，她逐渐出现头痛、全身乏力和不适症状，最终因全血细胞减少而就医检查。贫血是席汉综合征常见的血液学表现，而全血细胞减少则鲜有报道。然而，治疗后全血细胞减少完全恢复。全血细胞减少（由于骨髓无法产生细胞）在临床实践中是一个严重的发现，会引起极大的压力，因为它可能提示恶性肿瘤（主要是白血病）和其他严重疾病的诊断。尽管是罕见病因，但对于全血细胞减少的女性患者，医生仍需高度怀疑，以便在排除常见病因后，寻找全血细胞减少可能的可治疗病因（如席汉综合征）。
