Mishra Priya, Jindal Himanshu, Khan Efa, Palawat Sandeep S
Department of Internal Medicine, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, IND.
Cureus. 2023 Jan 19;15(1):e33972. doi: 10.7759/cureus.33972. eCollection 2023 Jan.
Sheehan syndrome is often a sequela of massive postpartum hemorrhage in resource-poor healthcare settings where blood loss during delivery is often neglected. The diagnosis of this rare but fatal disease is often delayed because the symptoms are vague and the pituitary dysfunction is insidious in nature. We report the case of a 35-year-old multiparous female with anhedonia and raised serum transaminases. She presented with constitutional symptoms. Her last vaginal delivery, six years back, was the last obstetric event that yielded a stillbirth child. She had had amenorrhea since then. Upon further evaluation, she was found to have a massive pericardial effusion, hypopituitarism, and a partially empty sella. This case report highlights the uncharacteristic symptoms that a patient presents with which ultimately lead to delayed diagnosis. Early diagnosis can go miles in improving the quality of life of the patient besides saving the patient from an adrenal crisis.
希恩综合征通常是资源匮乏的医疗环境中产后大出血的后遗症，在这种环境下，分娩期间的失血往往被忽视。这种罕见但致命疾病的诊断常常延迟，因为症状模糊，垂体功能障碍本质上隐匿。我们报告一例35岁多产女性病例，该患者有快感缺失及血清转氨酶升高。她有全身症状。她最后一次阴道分娩是在六年前，那次分娩产出一名死产儿，此后她一直闭经。经进一步评估，发现她有大量心包积液、垂体功能减退和部分空蝶鞍。本病例报告强调了患者出现的非典型症状最终导致诊断延迟。早期诊断除了能使患者免于肾上腺危象外，还能极大地改善患者生活质量。
