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Sheehan's Syndrome Revisited: Underlying Autoimmunity or Hypoperfusion?
Sheehan's syndrome remains a frequent obstetric complication with an uncertain pathophysiology. We aimed to assess the incidence of hypopituitarism (≥2 hormonal axis impairment) within the first six postchildbirth months and to determine the existence of anti-pituitary antibodies. From 2015 to...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846385/ https://www.ncbi.nlm.nih.gov/pubmed/29681937 http://dx.doi.org/10.1155/2018/8415860 |
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author | González-González, José Gerardo Borjas-Almaguer, Omar David Salcido-Montenegro, Alejandro Rodríguez-Guajardo, René Elizondo-Plazas, Anasofia Montes-de-Oca-Luna, Roberto Rodríguez-Gutiérrez, René |
author_facet | González-González, José Gerardo Borjas-Almaguer, Omar David Salcido-Montenegro, Alejandro Rodríguez-Guajardo, René Elizondo-Plazas, Anasofia Montes-de-Oca-Luna, Roberto Rodríguez-Gutiérrez, René |
author_sort | González-González, José Gerardo |
collection | PubMed |
description | Sheehan's syndrome remains a frequent obstetric complication with an uncertain pathophysiology. We aimed to assess the incidence of hypopituitarism (≥2 hormonal axis impairment) within the first six postchildbirth months and to determine the existence of anti-pituitary antibodies. From 2015 to 2017, adult pregnant women, who developed moderate to severe postpartum hemorrhage (PPH), were consecutively included in the study. Pituitary function was assessed 4 and 24 weeks after PPH. At the end of the study, anti-pituitary antibodies were assessed. Twenty women completed the study. Mean age was 26.35 (±5.83) years. The main etiology for severe PPH was uterine atony (65%) which resulted mostly in hypovolemic shock grades III-IV. Within the first four weeks after delivery, 95% of patients had at least one hormonal pituitary affected and 60% of the patients fulfilled diagnostic criteria for hypopituitarism. At the end of the study period, five patients (25%) were diagnosed with hypopituitarism (GH and cortisol axes affected). Anti-pituitary antibodies were negative in all patients. At 6 months follow-up, one in every four women with a history of moderate-to-severe PPH was found with asymptomatic nonautoimmune-mediated hypopituitarism. The role of autoimmunity in Sheehan's syndrome remains uncertain. Further studies are needed to improve the remaining knowledge gaps. |
format | Online Article Text |
id | pubmed-5846385 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-58463852018-04-22 Sheehan's Syndrome Revisited: Underlying Autoimmunity or Hypoperfusion? González-González, José Gerardo Borjas-Almaguer, Omar David Salcido-Montenegro, Alejandro Rodríguez-Guajardo, René Elizondo-Plazas, Anasofia Montes-de-Oca-Luna, Roberto Rodríguez-Gutiérrez, René Int J Endocrinol Research Article Sheehan's syndrome remains a frequent obstetric complication with an uncertain pathophysiology. We aimed to assess the incidence of hypopituitarism (≥2 hormonal axis impairment) within the first six postchildbirth months and to determine the existence of anti-pituitary antibodies. From 2015 to 2017, adult pregnant women, who developed moderate to severe postpartum hemorrhage (PPH), were consecutively included in the study. Pituitary function was assessed 4 and 24 weeks after PPH. At the end of the study, anti-pituitary antibodies were assessed. Twenty women completed the study. Mean age was 26.35 (±5.83) years. The main etiology for severe PPH was uterine atony (65%) which resulted mostly in hypovolemic shock grades III-IV. Within the first four weeks after delivery, 95% of patients had at least one hormonal pituitary affected and 60% of the patients fulfilled diagnostic criteria for hypopituitarism. At the end of the study period, five patients (25%) were diagnosed with hypopituitarism (GH and cortisol axes affected). Anti-pituitary antibodies were negative in all patients. At 6 months follow-up, one in every four women with a history of moderate-to-severe PPH was found with asymptomatic nonautoimmune-mediated hypopituitarism. The role of autoimmunity in Sheehan's syndrome remains uncertain. Further studies are needed to improve the remaining knowledge gaps. Hindawi 2018-02-26 /pmc/articles/PMC5846385/ /pubmed/29681937 http://dx.doi.org/10.1155/2018/8415860 Text en Copyright © 2018 José Gerardo González-González et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article González-González, José Gerardo Borjas-Almaguer, Omar David Salcido-Montenegro, Alejandro Rodríguez-Guajardo, René Elizondo-Plazas, Anasofia Montes-de-Oca-Luna, Roberto Rodríguez-Gutiérrez, René Sheehan's Syndrome Revisited: Underlying Autoimmunity or Hypoperfusion? |
title | Sheehan's Syndrome Revisited: Underlying Autoimmunity or Hypoperfusion? |
title_full | Sheehan's Syndrome Revisited: Underlying Autoimmunity or Hypoperfusion? |
title_fullStr | Sheehan's Syndrome Revisited: Underlying Autoimmunity or Hypoperfusion? |
title_full_unstemmed | Sheehan's Syndrome Revisited: Underlying Autoimmunity or Hypoperfusion? |
title_short | Sheehan's Syndrome Revisited: Underlying Autoimmunity or Hypoperfusion? |
title_sort | sheehan's syndrome revisited: underlying autoimmunity or hypoperfusion? |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846385/ https://www.ncbi.nlm.nih.gov/pubmed/29681937 http://dx.doi.org/10.1155/2018/8415860 |
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