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Partial Sheehan’s syndrome with abdominal tuberculosis presented with pancytopenia and fluctuating thyroid profile: a case report

Sheehan’s syndrome is a well-recognized cause of panhypopituitarism secondary to pituitary apoplexy, followed by postpartum hemorrhage. Depending upon the degree of ischemic injury, it can be either partial or complete. CASE PRESENTATION: We report an interesting case of a 35-year-old woman admitted...

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Autores principales: Yadav, Prashant, Bari, Md Anwarul, Saha, Akash, Yadav, Sushmita, Khan, Amzad H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010817/
https://www.ncbi.nlm.nih.gov/pubmed/36923749
http://dx.doi.org/10.1097/MS9.0000000000000244
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author Yadav, Prashant
Bari, Md Anwarul
Saha, Akash
Yadav, Sushmita
Khan, Amzad H.
author_facet Yadav, Prashant
Bari, Md Anwarul
Saha, Akash
Yadav, Sushmita
Khan, Amzad H.
author_sort Yadav, Prashant
collection PubMed
description Sheehan’s syndrome is a well-recognized cause of panhypopituitarism secondary to pituitary apoplexy, followed by postpartum hemorrhage. Depending upon the degree of ischemic injury, it can be either partial or complete. CASE PRESENTATION: We report an interesting case of a 35-year-old woman admitted to our hospital with complaints of abdominal distension, which was later presumed to be due to disseminated tuberculosis (TB) after excluding the possible differentials. During the treatment course, she was going through repeated attacks of hypovolemic shock and hypoglycemia due to adrenocortical insufficiency. This, along with the history of prolonged amenorrhea 4 years back due to severe postpartum hemorrhage in her last pregnancy, has led us to our diagnosis of partial Sheehan’s syndrome. After 1 month of starting steroid and anti-TB therapy, it was quite surprising when she presented with features of pancytopenia and antitubercular drug-induced hepatitis. DISCUSSION: Sheehan’s syndrome may have a varying degree of presentation depending upon the degree of damage to the pituitary gland, which includes amenorrhea, lactation failure, adrenocortical insufficiency, hyponatremia, hypoglycemia, as well as pancytopenia in some rare instances The hormone panel especially the thyroid profile should be monitored carefully. Such cases are often challenging to deal with because of their varying degrees of presentation and the delay in diagnosis due to a lack of clinical suspicion. CONCLUSION: Therefore, we believe that this rare presentation of pancytopenia in Sheehan’s syndrome with fluctuating thyroid profile and abdominal TB in the background will let clinicians approach such a rare disease differently.
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spelling pubmed-100108172023-03-14 Partial Sheehan’s syndrome with abdominal tuberculosis presented with pancytopenia and fluctuating thyroid profile: a case report Yadav, Prashant Bari, Md Anwarul Saha, Akash Yadav, Sushmita Khan, Amzad H. Ann Med Surg (Lond) Case Reports Sheehan’s syndrome is a well-recognized cause of panhypopituitarism secondary to pituitary apoplexy, followed by postpartum hemorrhage. Depending upon the degree of ischemic injury, it can be either partial or complete. CASE PRESENTATION: We report an interesting case of a 35-year-old woman admitted to our hospital with complaints of abdominal distension, which was later presumed to be due to disseminated tuberculosis (TB) after excluding the possible differentials. During the treatment course, she was going through repeated attacks of hypovolemic shock and hypoglycemia due to adrenocortical insufficiency. This, along with the history of prolonged amenorrhea 4 years back due to severe postpartum hemorrhage in her last pregnancy, has led us to our diagnosis of partial Sheehan’s syndrome. After 1 month of starting steroid and anti-TB therapy, it was quite surprising when she presented with features of pancytopenia and antitubercular drug-induced hepatitis. DISCUSSION: Sheehan’s syndrome may have a varying degree of presentation depending upon the degree of damage to the pituitary gland, which includes amenorrhea, lactation failure, adrenocortical insufficiency, hyponatremia, hypoglycemia, as well as pancytopenia in some rare instances The hormone panel especially the thyroid profile should be monitored carefully. Such cases are often challenging to deal with because of their varying degrees of presentation and the delay in diagnosis due to a lack of clinical suspicion. CONCLUSION: Therefore, we believe that this rare presentation of pancytopenia in Sheehan’s syndrome with fluctuating thyroid profile and abdominal TB in the background will let clinicians approach such a rare disease differently. Lippincott Williams & Wilkins 2023-02-13 /pmc/articles/PMC10010817/ /pubmed/36923749 http://dx.doi.org/10.1097/MS9.0000000000000244 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Case Reports
Yadav, Prashant
Bari, Md Anwarul
Saha, Akash
Yadav, Sushmita
Khan, Amzad H.
Partial Sheehan’s syndrome with abdominal tuberculosis presented with pancytopenia and fluctuating thyroid profile: a case report
title Partial Sheehan’s syndrome with abdominal tuberculosis presented with pancytopenia and fluctuating thyroid profile: a case report
title_full Partial Sheehan’s syndrome with abdominal tuberculosis presented with pancytopenia and fluctuating thyroid profile: a case report
title_fullStr Partial Sheehan’s syndrome with abdominal tuberculosis presented with pancytopenia and fluctuating thyroid profile: a case report
title_full_unstemmed Partial Sheehan’s syndrome with abdominal tuberculosis presented with pancytopenia and fluctuating thyroid profile: a case report
title_short Partial Sheehan’s syndrome with abdominal tuberculosis presented with pancytopenia and fluctuating thyroid profile: a case report
title_sort partial sheehan’s syndrome with abdominal tuberculosis presented with pancytopenia and fluctuating thyroid profile: a case report
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010817/
https://www.ncbi.nlm.nih.gov/pubmed/36923749
http://dx.doi.org/10.1097/MS9.0000000000000244
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