Comparisons of clinical and hormonal characteristics of Sheehan′s syndrome between different diagnosis duration after obstetrical event

Seventy-two cases diagnosed as Sheehan′s syndrome in our hospital from January 1999 to May 2014 were divided into two groups according to the diagnosis duration from the obstetrical event to diagnosis: ≤5 years(n=38)and >5 years(n=34). The medical history, physical examination findings, and hormonal profiles were retrospectively reviewed and analyzed. The mean age at diagnosis was(42.5±11.8)years, with a mean diagnostic duration of(9.0±9.3)years. 71(98.6%)of these patients had a history of obstetric hemorrhage. The most common clinical presentation included amenorrhea(59/72, 81.9%), agalactia(52/72, 72.2%), and loss of axillary or pubic hair(61/72, 84.7%). The numbers with decreasing homornal levels were LH(63), FSH(58), estradiol(54), TSH(59), TT3(58), TT4(57), ACTH(37), and serum cortisol(60). The ratio of peripartum hysterectomy(13.1% vs 0, P=0.029)and the incidences of hypoglycemia(42.1% vs 14.7%, P=0.018)and hyponatremia(52.6% vs 23.5%, P=0.016)in diagnosis duration ≤5years group was significantly higher than those of >5 years group. There was no statistical difference in hypotension, loss of lactation, postpartum amenorrhea, low body temperature, and low body weight between two groups. The proportion of the diminished hypothalamic-pituitary-adrenal axis in diagnosis duration≤5 years group was higher than that in >5 years group(92.1% vs 73.5%, P=0.036). There were no differences in the proportions of impaired hypothalamic-pituitary-thyroid axis(81.6% vs 82.4%)and hypothalamic-pituitary-gonadal axis(92.1% vs 91.2%)between two groups. (Chin J Endocrinol Metab, 2016, 32: 841-845) Key words: Sheehan′s syndrome; Hypopituitarism; Diagnosis duration