Sheehan Syndrome Presenting as Central Diabetes Insipidus: A Rare Presentation of an Uncommon Disorder
| Autor: | Daryl Burrows, Saumya Kumar, Shyam Dang, Debra L. Simmons |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Disseminated intravascular coagulation medicine.medical_specialty Pediatrics business.industry Endocrinology Diabetes and Metabolism General Medicine medicine.disease Hypopituitarism Surgery Diabetes Insipidus Neurogenic Sheehan Syndrome Endocrinology Polyuria Hypovolemia Diabetes insipidus Urine osmolality Humans Medicine Female medicine.symptom business Complication Desmopressin medicine.drug |
| Zdroj: | Endocrine Practice. 17:108-114 |
| ISSN: | 1530-891X |
| DOI: | 10.4158/ep10015.cr |
| Popis: | Objective To add to the current scant literature on rare clinical presentations of Sheehan syndrome. Methods We describe the study patient’s clinical, laboratory, and imaging findings and review the literature for publications regarding varied clinical presentations of Sheehan syndrome. Results A 36-year-old multigravida woman developed severe postpartum hemorrhage and disseminated intravascular coagulation followed by Sheehan syndrome, with central diabetes insipidus as the primary presenting feature. This was diagnosed when, postoperatively, she developed polyuria with a urine output of 11 L in 24 hours with an accompanying rise in creatinine. She had laboratory evidence of diabetes insipidus, with serum osmolality greater than urine osmolality. Her clinical status improved significantly with intranasal desmopressin supplementation, thus confirming the diagnosis of Sheehan syndrome. Although Sheehan syndrome is a known complication of postpartum hemorrhage, central diabetes insipidus is seldom considered or suspected. Hypovolemia is usually presumed to be secondary to blood loss and polyuria resulting from a diuretic phase of acute renal failure. Conclusions It is important to consider posterior pituitary ischemia resulting from Sheehan syndrome presenting as central diabetes insipidus as a cause of polyuria because appropriate hormonal replacement initiated early can possibly improve clinical status and patient outcomes. (Endocr Pract. 2011;17:108-114) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|