Year :
2024
| Month :
April
| Volume :
18
| Issue :
4
| Page :
OD01 - OD04
A Rare Case of Sheehan’s Syndrome Presenting as Depression and Dyselectrolytaemia in a Multiparous Woman
M Maneesha, KS Chenthil, Vignessh Raveekumaran, J Jenifer Florence Mary
1. First Year Resident, Department of General Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed to be University),
Puducherry, India.
2. Professor, Department of General Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed to be University), Puducherry,
India.
3. Assistant Professor, Department of General Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed to be University),
Puducherry, India. ORCID ID: 0009-0006-6283-6542.
4. Assistant Professor, Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed to be University),
Puducherry, India. ORCID ID: 0000-0001-8869-2416.
Correspondence Address :
Dr. Vignessh Raveekumaran,
Assistant Professor, Department of General Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed to be University), Puducherry-607402, India.
E-mail: vignesshravee@gmail.com
Abstract
Sheehan’s Syndrome (SS) is a rare endocrine condition that presents with complex features in women with intrapartum or Postpartum Haemorrhage (PPH) seen in clinical practice. The spectrum of symptoms is diverse, and early detection with prompt treatment of this endocrinopathy is facilitated by a high index of suspicion, sound clinical acumen, and an appropriate diagnostic strategy by an astute physician. SS, which manifests as a major depressive disorder, but not accompanied with dyselectrolytaemia, is an interesting finding in the present case study. In fact, most of the time, it presents with non specific symptoms that delays the diagnosis and management. Hereby, the authors present the case of a 39-year-old multiparous woman who was diagnosed with depression for two months by the psychiatrist. Later, she developed symptoms including anorexia, for which she presented to the Medicine Department. On detailed examination, her vitals were poor. Again, she was evaluated in detail for her obstetric history presented as a history of agalactia and early amenorrhoea two years ago. Followed by the history, laboratory investigation and imaging techniques were done, and found to have thinned pituitary gland and flattened against the sella floor. With this prompt examination, diagnosed with SS due to PPH. Yet, her laboratory investigation resulted in abnormal electrolytes made the final diagnosis as SS with dyselectrolytaemia and depression as neuropsychiatric manifestations. She was treated with Hormone Replacement Therapy (HRT). Due to her financial constraints, her treatment switched to oral drugs and discharged Against Medical Advice (AMA) with follow-up advice.
Keywords
Hypopituitarism, Multiparity, Postpartum haemorrhage, Postpartum pituitary necrosis
DOI and Others
DOI: 10.7860/JCDR/2024/68634.19233
Date of Submission: Nov 17, 2023
Date of Peer Review: Jan 15, 2024
Date of Acceptance: Feb 13, 2024
Date of Publishing: Apr 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Nov 21, 2023
• Manual Googling: Jan 16, 2024
• iThenticate Software: Feb 09, 2024 (4%)
ETYMOLOGY: Author Origin
EMENDATIONS: 8
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