Endocrinol Metab.  2012 Mar;27(1):54-58. 10.3803/EnM.2012.27.1.54.

A Case of Sheehan's Syndrome with Pancytopenia

• Lee HS
• Kwon BW
• Han JH
• Kim HJ

• KMID: 2134818
• DOI: http://doi.org/10.3803/EnM.2012.27.1.54

Abstract

Sheehan's syndrome is characterized by varying degrees of anterior pituitary dysfunction due to postpartum ischemic necrosis of the pituitary gland after massive bleeding. The spectrum of clinical presentation of Sheehan's syndrome is broad, with changes from nonspecific complaints, such as weakness, fatigue, and anemia, to severe pituitary insufficiency resulting in coma and death. Normochromic anemia is commonly associated with Sheehan's syndrome, but pancytopenia is rarely observed in patients with Sheehan's syndrome. We describe a 57-year-old woman with Sheehan's syndrome who presented with pancytopenia that was treated by hormone replacement with levothyroxine and glucocorticoid.

Keyword

Glucocorticoids; Hypopituitarism; Pancytopenia; Thyroxine

MeSH Terms

Anemia
Coma
Fatigue
Female
Glucocorticoids
Hemorrhage
Humans
Hypopituitarism
Middle Aged
Necrosis
Pancytopenia
Pituitary Gland
Postpartum Period
Thyroxine
Glucocorticoids
Thyroxine

Figure

• 

  Fig. 1 Bone marrow biopsy section revealed decreased hematopoiesis with hypocellularity (A, H&E stain, × 40; B, H&E stain, × 100). The overall cellularity is about 10%.

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  Fig. 2 Magnetic resonance imaging of the patient's sella. Pituitary gland was not detected on coronal (A) and sagittal (B) images. Only sella tucica was filled with the cerebrospinal fluid (empty sella).

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