SHEEHAN SYNDROME PRESENTING WITH SEVERE HYPONATREMIA: A CASE REPORT

Tran Gia Bao 1 , , Tran Nhu Thao 1 , Nguyen Hoang Thi An 2 , Nguyen Thanh Vy 1, 2 , Pham Hoa Binh 1, 2 , Nguyen Thi May Hong 2
1 University of Medicine and Pharmacy at Ho Chi Minh City image/svg+xml
2 Thong Nhat Hospital image/svg+xml
* Corresponding author:

Article Information

Metrics
Downloads: 7 Views: 23
DOI
10.63947/bvtn.v1i5.22
Published
2025-11-01
Issue Vol. 1 No. 5 (2025): Thong Nhat Hospital’s 50-Year Journey - Comprehensive Healthcare and Healthy Aging
Section
Case Report
Categories
Research

Download Article

PDF

How to Cite

1.
Gia Bao T, Nhu Thao T, Hoang Thi An N, Thanh Vy N, Hoa Binh P, Thi May Hong N. SHEEHAN SYNDROME PRESENTING WITH SEVERE HYPONATREMIA: A CASE REPORT. JHA [Internet]. Vietnam; 2025 Nov. 1 [cited 2025 Nov. 5];1(5):139–143. https://tcsuckhoelaohoa.vn/bvtn/article/view/91 doi: 10.63947/bvtn.v1i5.22
Loading citation...
Crossref
Scopus
Google Scholar
Europe PMC

Abstract

Sheehan syndrome, characterized by pituitary necrosis secondary to postpartum hemorrhage, results in partial or complete hypopituitarism. Diagnosis is often delayed due to its nonspecific clinical manifestations; however, the condition can lead to life-threatening complications such as hyponatremia. We present the case of a 56-year-old woman admitted with symptomatic severe chronic hyponatremia, who was subsequently diagnosed with panhypopituitarism caused by Sheehan syndrome. The patient was successfully managed with hypertonic saline infusion and hormone replacement therapy (levothyroxine and hydrocortisone). This case emphasizes the importance of obtaining a thorough obstetric history and maintaining a high index of suspicion for Sheehan syndrome in middle-aged women presenting with unexplained hyponatremia.

Keywords

Sheehan syndrome hyponatremia hypopituitarism

References

  1. "Postpartum necrosis of the anterior pituitary", by H.L. Sheehan, Journal of Pathology and Bacteriology, vol. 45, pp. 189-214, 1937. American journal of obstetrics and gynecology. 1971;111(6):851. Epub 1971/11/01. PubMed PMID: 4944349.
  2. Regal M, Paramo C, Sierra SM, Garcia-Mayor RV. Prevalence and incidence of hypopituitarism in an adult Caucasian population in northwestern Spain. Clin Endocrinol (Oxf). 2001;55(6):735-40. Epub 2002/03/16. doi: 10.1046/j.1365-2265.2001.01406.x. PubMed PMID: 11895214. DOI: https://doi.org/10.1046/j.1365-2265.2001.01406.x
  3. Zargar AH, Singh B, Laway BA, Masoodi SR, Wani AI, Bashir MI. Epidemiologic aspects of postpartum pituitary hypofunction (Sheehan's syndrome). Fertil Steril. 2005;84(2):523-8. Epub 2005/08/09. doi: 10.1016/j.fertnstert.2005.02.022. PubMed PMID: 16084902. DOI: https://doi.org/10.1016/j.fertnstert.2005.02.022
  4. Kristjansdottir HL, Bodvarsdottir SP, Sigurjonsdottir HA. Sheehan's syndrome in modern times: a nationwide retrospective study in Iceland. Eur J Endocrinol. 2011;164(3):349-54. Epub 2010/12/25. doi: 10.1530/EJE-10-1004. PubMed PMID: 21183555. DOI: https://doi.org/10.1530/EJE-10-1004
  5. Karaca Z, Kelestimur F. Sheehan syndrome: a current approach to a dormant disease. Pituitary. 2025;28(1):20. Epub 2025/01/26. doi: 10.1007/s11102-024-01481-1. PubMed PMID: 39863703; PubMed Central PMCID: PMC11762620. DOI: https://doi.org/10.1007/s11102-024-01481-1
  6. Diri H, Tanriverdi F, Karaca Z, Senol S, Unluhizarci K, Durak AC, et al. Extensive investigation of 114 patients with Sheehan's syndrome: a continuing disorder. Eur J Endocrinol. 2014;171(3):311-8. Epub 2014/06/12. doi: 10.1530/EJE-14-0244. PubMed PMID: 24917653. DOI: https://doi.org/10.1530/EJE-14-0244
  7. Ramiandrasoa C, Castinetti F, Raingeard I, Fenichel P, Chabre O, Brue T, et al. Delayed diagnosis of Sheehan's syndrome in a developed country: a retrospective cohort study. Eur J Endocrinol. 2013;169(4):431-8. Epub 2013/07/19. doi: 10.1530/EJE-13-0279. PubMed PMID: 23864341. DOI: https://doi.org/10.1530/EJE-13-0279
  8. Gei-Guardia O, Soto-Herrera E, Gei-Brealey A, Chen-Ku CH. Sheehan syndrome in Costa Rica: clinical experience with 60 cases. Endocr Pract. 2011;17(3):337-44. Epub 2010/11/03. doi: 10.4158/EP10145.OR. PubMed PMID: 21041170. DOI: https://doi.org/10.4158/EP10145.OR
  9. Lim CH, Han JH, Jin J, Yu JE, Chung JO, Cho DH, et al. Electrolyte Imbalance in Patients with Sheehan's Syndrome. Endocrinol Metab (Seoul). 2015;30(4):502-8. Epub 2015/10/21. doi: 10.3803/EnM.2015.30.4.502. PubMed PMID: 26485467; PubMed Central PMCID: PMC4722405. DOI: https://doi.org/10.3803/EnM.2015.30.4.502
  10. [10] Kurtulmus N, Yarman S. Hyponatremia as the presenting manifestation of Sheehan's syndrome in elderly patients. Aging Clin Exp Res. 2006;18(6):536-Epub 2007/01/27. doi: 10.1007/BF03324855. PubMed PMID: 17255644. DOI: https://doi.org/10.1007/BF03324855
  11. Schury MP, Adigun R. Sheehan Syndrome. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Rotimi Adigun declares no relevant financial relationships with ineligible companies.2025.
  12. Dejager S, Gerber S, Foubert L, Turpin G. Sheehan's syndrome: differential diagnosis in the acute phase. J Intern Med. 1998;244(3):261-6. Epub 1998/09/25. doi: 10.1046/j.1365-2796.1998.00370.x. PubMed PMID: 9747750. DOI: https://doi.org/10.1046/j.1365-2796.1998.00370.x

License

© 2025 The Author(s). Published by Journal of Health and Aging.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.