SHEEHAN’S

SYNDROME

By;WARDA SHAKIL

Other Names for this Disease:-

•Postpartum hypopituitarism•Postpartum panhypopituitarism•Postpartum panhypopituitary syndrome•Postpartum pituitary necrosis•Simmond's disease

DEFINATION:-

Characteristically caused by ischemic necrosis of most of the anterior pituitary gland which results from spasm in its arterioles, occurring at the time of severe hemorrhage or shock (usually postpartum) complicating child birth.

4% of women who loose large amount of blood suffer some degree of damage to Anterior Pituitary Gland.8% suffer moderately50% suffer severely ; having postpartum hypopituitarism ending up in shock.

CAUSES:-

Sheehan syndrome is caused by severe blood loss during or after childbirth. Blood loss at that time can be particularly damaging to the pituitary gland (which enlarges during pregnancy), destroying hormone-producing tissue so that the gland cannot function properly.

CLINICS:-

In the fully developed syndrome; which is only seen when 95% of the Anterior Pituitary Gland is destroyed, all functions:-LactogenicThyrotropicCorticotropicSomatotropic are IMPAIRED

SIGNS:-Agalactia is the first and foremost most signAmenorrheaEvidence of HypothyroidismDecreased insulin tolerance- HypoglycemiaSigns of Adreno-cortical failure:-(axillary sweating absent, loss of axillary and pubic hair, decrease in skin pigmentation)WeaknessFatigueDizzinessOligomenorrhea (infrequent menstrual periods)Hot flashesDecreased libidoLow blood pressureSlowed mental functioningWeight gainDifficulty staying warm

These women also have moderate anemia- by lack of pituitary erytropoetic factorSevere atrophy of all genital organs including reproductive organsLoss of breast tissueDry vaginal mucousAtrophy of subcutaneous fatPremature Aging

DIAGNOSE:-

Clinical Signs And Patient HistoryLab Analysis of various hormonal levelsCT-Scan/ MRI of Brain (targeting Pituitary Gland)

TREATMENT:-

Treatment involved lifelong estrogen and progesterone hormone replacement therapy. Thyroid and adrenal hormones also must be taken.

SIMMOND’S SYNDROME

(HYPOPHYSEAL CACHEXIA)

By;WARDA SHAKIL

Simmond’s Syndrome and Sheehan’s Syndrome are quite similar and according to various literature there is no such difference between the two but in reality they do have few differences which goes as follows:- SIMMOND’S SYNDROME:- Etiology:- Inflammatory disease of Brain or Pituitary Tumor Clinical Sign:- Significant weight loss (Hypophyseal Cachexia) Treatment:- Antibiotic Therapy or Surgery