Sheehan's syndrome

Sheehan's syndrome

Infobox_Disease
Name = Sheehan syndrome


Caption =
DiseasesDB = 11998
ICD10 = ICD10|E|23|0|e|20
ICD9 = ICD9|253.2
ICDO =
OMIM =
MedlinePlus = 001175
eMedicineSubj = med
eMedicineTopic = 1914
MeshID = D007018

Sheehan syndrome, also known as postpartum hypopituitarism or postpartum pituitary necrosis, is hypopituitarism (decreased functioning of the pituitary gland), caused by necrosis due to blood loss and hypovolemic shock during and after childbirth.

Causes

It is a rare complication of pregnancy, usually occurring after excessive blood loss; the presence of disseminated intravascular coagulation (i.e., in amniotic fluid embolism or HELLP syndrome) also appears to be a factor in its development.

Pathophysiology

Hypertrophy and hyperplasia of lactotrophs during pregnancy results in the enlargement of the anterior pituitary, without a corresponding increase in blood supply.

Secondly, the anterior pituitary is supplied by a low pressure portal venous system. [http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=endocrin&part=A1257 under heading "Sheehan's syndrome"]

These vulnerabilities, when affected by major hemorrhage or hypotension during the peripartum period, can result in ischaemia of the affected pituitary regions leading to necrosis.

The posterior pituitary is usually not affected due to its direct arterial supply.

Eponym

It is named for Harold Sheehan. [WhoNamedIt|synd|2009] [H. L. Sheehan. Post-partum necrosis of anterior pituitary. The Journal of Pathology and Bacteriology, Chichester, 1937, 45: 189-214.]

References

External links

*
* [http://www.pathology.vcu.edu/education/endocrine/lab1.e.html Pathology at vcu.edu]


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