گزارش 18 مورد بیمار مبتلا به سندرم شیهان

Sheehan’s syndrome has a broad spectrum of clinical and laboratory signs that range from nonspecific symptoms such as malaise, fatigue and anemia to severe hypophyseal insufficiency, which results in coma and death. We collected data from 18 patients diagnosed with Sheehan’s syndrome during the past 10 years. Patients profiles, including history, physical examination, clinical presentation that lead to diagnosis, routine biochemical tests, lipid profiles, thyroid function tests, and basal hypophyseal hormone levels were reviewed. The time spent for making a definitive diagnosis of the disease ranged between 10 to 30 years with a mean of 15.55 ± 5.04 years. Five patients (22%) had disturbances in their levels of consciousness at the time of presentation (four with hypoglycemia, one with severe hypothyroidism). Seven patients (39%) were evaluated for central hypothyroidism in outpatient service before definite diagnosis. All of the patients had a history of massive hemorrhage at delivery and lack of postpartum milk production. All of the patients have received replacement doses of Levothyroxine and Prednisolone. Considering the duration of disease, significant delays appear to occur in its diagnosis and treatment.