É uma causa rara de problemas na glândula hipófise, que acontece depois de uma hemorragia grave no pós-parto. A falta prolongada de sangue (hipovolemia) faz com que parte da hipófise seja destruída por não receber oxigênio suficiente. Os sintomas geralmente aparecem no pós-parto e incluem dificuldade em amamentar, cansaço extremo, pressão baixa e, com o tempo, a ausência de menstruação (amenorreia). O quadro costuma ser leve, mas em casos mais graves pode levar à falha das glândulas adrenais. O prognóstico é melhor quando a reposição hormonal é iniciada logo após o começo dos sintomas.
Introdução
O que você precisa saber de cara
É uma causa rara de problemas na glândula hipófise, que acontece depois de uma hemorragia grave no pós-parto. A falta prolongada de sangue (hipovolemia) faz com que parte da hipófise seja destruída por não receber oxigênio suficiente. Os sintomas geralmente aparecem no pós-parto e incluem dificuldade em amamentar, cansaço extremo, pressão baixa e, com o tempo, a ausência de menstruação (amenorreia). O quadro costuma ser leve, mas em casos mais graves pode levar à falha das glândulas adrenais. O prognóstico é melhor quando a reposição hormonal é iniciada logo após o começo dos sintomas.
Escala de raridade
<1/50kMuito rara
1/20kRara
1/10kPouco freq.
1/5kIncomum
1/2k
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
+ 24 sintomas em outras categorias
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 49 características clínicas mais associadas, ordenadas por frequência.
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Nenhum gene associado encontrado
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Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Síndrome Sheehan
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Publicações mais relevantes
Total hip arthroplasty and perioperative management of a patient with hip osteonecrosis secondary to hypopituitarism due to Sheehan syndrome: a case report and literature review.
Sheehan's syndrome, a rare disorder resulting from postpartum hemorrhage-induced necrosis of the anterior pituitary gland, necessitates long-term hormone replacement therapy with glucocorticoids. This predisposes patients to severe complications, including rapid-progression osteonecrosis of the femoral head (ONFH), which carries a high disability rate. We report a 63-year-old female with Sheehan's syndrome diagnosed 30 years ago, managed with sustained prednisone and levothyroxine. She presented with 10 years of bilateral hip pain and imaging-confirmed bilateral ONFH at ARCO stage IV. A multidisciplinary team (MDT) approach was implemented: endocrinology optimized preoperative hormone regimens, orthopedics planned total hip arthroplasty (THA) based on bone density assessments, and anesthesiology confirmed tolerability for intraspinal anesthesia. After stabilizing physiological parameters, left THA was performed. Intraoperative hydrocortisone infusion maintained hormonal homeostasis. The surgery proceeded uneventfully; however, an allergic reaction occurred during blood transfusion, which was promptly controlled. Postoperative MDT-coordinated care enabled ambulation with a walker within one week, with unrestricted left hip mobility and no complications (e.g., infection, prosthesis loosening). THA for glucocorticoid-induced ONFH in Sheehan's syndrome entails challenges such as perioperative hormonal instability, elevated infection risk, and impaired bone healing. The MDT approach ensures comprehensive risk mitigation, facilitating surgical success and patient safety. Long-term follow-up for hormone levels, bone density, and prosthesis status is warranted.
Cytomegalovirus colitis in a woman with Sheehan syndrome.
Cytomegalovirus (CMV) colitis is typically associated with impaired cellular immunity, but has been increasingly recognized in elderly individuals or those with subtle immune dysfunction. Sheehan syndrome, a form of postpartum hypopituitarism, leads to chronic hormonal deficiencies and lifelong glucocorticoid replacement, which may contribute to mild but clinically relevant immune vulnerability. Reports of CMV colitis in patients with Sheehan syndrome are extremely rare. We report a 70-year-old woman who presented with several days of right lower quadrant abdominal pain and diarrhea. Physical examination and imaging revealed no evidence of acute appendicitis or other surgical conditions. Despite empirical antibiotic therapy, her symptoms persisted, prompting upper and lower endoscopy, which demonstrated multiple ulcerative lesions throughout the gastrointestinal tract. Histopathological examination with immunohistochemical staining confirmed CMV colitis. Further evaluation revealed long-standing Sheehan syndrome with secondary hypothyroidism, adrenal insufficiency, and suppressed gonadotropins. She had been receiving cortisone replacement for several years. The patient was treated with intravenous ganciclovir followed by oral valganciclovir, resulting in complete clinical resolution. This case highlights that CMV colitis can occur in older adults without classical immunosuppressive risk factors and that endocrine disorders such as Sheehan syndrome may contribute to subtle immune impairment. Chronic hypopituitarism combined with long-term glucocorticoid replacement may create a permissive environment for CMV development. Clinicians should consider CMV colitis when evaluating persistent gastrointestinal symptoms in elderly patients with endocrine dysfunction or chronic corticosteroid use.
Complete Atrioventricular Block: An Exceedingly Rare Manifestation of Pituitary Crisis in Sheehan Syndrome.
Recurrent Symptomatic Hyponatremia Revealing a Late Diagnosis of Sheehan Syndrome and Effectively Treated With Levothyroxine: A Case Report and Brief Review of Literature.
In women with a history of postpartum hemorrhage presenting with chronic symptoms such as hyponatremia, amenorrhea, weight loss, or cold intolerance, suspect Sheehan's syndrome. Early diagnosis and prompt hormonal replacement therapy are essential for reversing complications and improving quality of life. Prioritize evaluation of pituitary function in these patients to ensure timely intervention.
Abnormal Blood Pressure Dipping Pattern in Women with Hypopituitarism Secondary to Sheehan Syndrome: A Case-Control Study.
The aims of this study were to assess the 24-hour ambulatory BP levels and to determine the prevalence of abnormal circadian BP dipping patterns in women with hypopituitarism secondary to Sheehan syndrome. This was a cross-sectional study including 35 women with complete anterior hypopituitarism secondary to Sheehan syndrome and 47 age- and body-mass index-matched control women. Subjects receiving treatment for hypertension were not included. All participants underwent clinical examination, laboratory tests, and BP measurement using ambulatory 24-hour monitoring. The mean age was 61.3±10.6 years in patients vs 60.5±8.5 years in controls (p=0.720). Compared to controls, women with Sheehan syndrome had a higher prevalence of dyslipidemia (p=0.032) and metabolic syndrome (p=0.028). The prevalence of hypertension was 68% in patients and 62% in controls (p=0.520). Altered day-night BP variation was more frequent in patients (85%) than in controls (54%) (p=0.004). Additionally, patients had a significantly higher prevalence of nocturnal hypertension (38% versus 3%; p=0.002). Sheehan syndrome was positively associated with a non-dipper and riser BP profile (Odds Ratio=4.7, 95% confidence interval: 1.54-14.33, p=0.004). Women with hypopituitarism secondary to Sheehan syndrome had a higher disruption of the circadian BP rhythm than controls. Although the prevalence of newly diagnosed hypertension was comparable between patients and controls, women with Sheehan syndrome had a higher prevalence of nocturnal hypertension.
Publicações recentes
Recurrent Symptomatic Hyponatremia Revealing a Late Diagnosis of Sheehan Syndrome and Effectively Treated With Levothyroxine: A Case Report and Brief Review of Literature.
Complete Atrioventricular Block: An Exceedingly Rare Manifestation of Pituitary Crisis in Sheehan Syndrome.
Total hip arthroplasty and perioperative management of a patient with hip osteonecrosis secondary to hypopituitarism due to Sheehan syndrome: a case report and literature review.
Abnormal Blood Pressure Dipping Pattern in Women with Hypopituitarism Secondary to Sheehan Syndrome: A Case-Control Study.
An overview of hypopituitarism's causes.
📚 EuropePMC149 artigos no totalmostrando 88
Recurrent Symptomatic Hyponatremia Revealing a Late Diagnosis of Sheehan Syndrome and Effectively Treated With Levothyroxine: A Case Report and Brief Review of Literature.
Clinical case reportsComplete Atrioventricular Block: An Exceedingly Rare Manifestation of Pituitary Crisis in Sheehan Syndrome.
CJC openTotal hip arthroplasty and perioperative management of a patient with hip osteonecrosis secondary to hypopituitarism due to Sheehan syndrome: a case report and literature review.
Frontiers in surgeryAbnormal Blood Pressure Dipping Pattern in Women with Hypopituitarism Secondary to Sheehan Syndrome: A Case-Control Study.
Sisli Etfal Hastanesi tip bulteniAn overview of hypopituitarism's causes.
Frontiers in endocrinologyCytomegalovirus colitis in a woman with Sheehan syndrome.
QJM : monthly journal of the Association of PhysiciansUnusual Presentation of Hypopituitarism Caused by Internal Carotid Artery Aneurysm.
CureusA case report of acute Sheehan syndrome with a review of 29 existing reports from 1990 to 2024: is it still considered a rare disease?
Frontiers in surgeryGrowth Hormone Therapy Restores Fertility in a Woman With Isolated Growth Hormone Deficiency From Chronic Sheehan Syndrome.
JCEM case reportsAdrenal Crisis Induced by Viral Myocarditis Unveils Sheehan Syndrome at 16 Years Postpartum: A Case Report.
Clinical case reportsLifting the Veil: Delayed Diagnosis of Sheehan Syndrome Unmasked by Adrenal Crisis.
JCEM case reportsA case of adrenal insufficiency presenting with seizures, complicated by developmental cerebral venous anomaly and Takotsubo cardiomyopathy: a case report.
Journal of medical case reportsIncreased levels of inflammatory markers and carotid intima-media thickness in asymptomatic patients with Sheehan syndrome without growth hormone replacement therapy.
Archives of endocrinology and metabolismMitraClip intervention for Sheehan syndrome complicated by dilated cardiomyopathy and valvular insufficiency: a case report and literature review.
Frontiers in endocrinologyMyxedema Coma Nested Inside Sheehan Syndrome: A Diagnosis Not to Be Missed.
JCEM case reportsA case of hypopituitarism with pancytopenia cured by corticosteroid and thyroid hormone replacement therapy.
Endocrinology, diabetes & metabolism case reportsQT Prolongation and Torsades De Pointes Due to Undiagnosed Sheehan Syndrome: A Rare Cause of Lethal Arrhythmia.
CureusAcute Sheehan Syndrome With Distinctive Arginine Vasopressin Secretion and Magnetic Resonance Imaging Findings.
JCEM case reportsComputed Tomography Cardiac Angiography Findings in Patients With Sheehan Syndrome.
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical EndocrinologistsUsing the brain to heal the heart: A case discussion and review of panhypopituitarism-induced chronic heart and kidney failure.
JHLT openAcute Sheehan's syndrome.
Ceska gynekologieSheehan syndrome: a current approach to a dormant disease.
PituitaryClinical Characteristics, and Prevalence of Hepatic and Bone Mineral Density Abnormalities in Patients With Sheehan Syndrome: Data From a Tertiary Care Center.
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical EndocrinologistsAcute Sheehan syndrome following massive postpartum hemorrhage due to vulvar hematoma.
AJOG global reportsProlactin deficiency in the context of other pituitary hormone abnormalities : Special issue: hypoprolactinemia: a neglected endocrine disorder.
Reviews in endocrine & metabolic disordersSheehan Syndrome Unmasked by Adrenal Crisis Secondary to Severe Dengue Fever.
Ochsner journalAnterior and Posterior Pituitary Function in Patients with Sheehan Syndrome - Combining the use of Insulin Tolerance Test and Copeptin Assay.
Indian journal of endocrinology and metabolismCardiovascular Risk Factors in Sheehan's Syndrome: A Case-Control Study.
Indian journal of endocrinology and metabolism[High fever in a 39 year-old woman].
La Revue de medecine interneA Case Report of Sheehan Syndrome: A Rare Cause of Hypopituitarism.
CureusA Case Report of Hemolytic Hyponatremia.
CureusAcute Sheehan syndrome revealed by neuropsychiatric disorders.
International journal of obstetric anesthesiaSella Turcica Size in Women with Sheehan Syndrome-A Case-Control Study.
Indian journal of endocrinology and metabolismAsymptomatic trigger of adrenal crisis in a patient with Sheehan syndrome: importance of timely recognition and intervention.
BMJ case reportsIntra-uterine packing: an effective and affordable tool in the management of post-partum hemorrhage - cohort study.
The Pan African medical journalPostpartum acute adrenal insufficiency of early-onset Sheehan syndrome: A case series study in a single center.
The journal of obstetrics and gynaecology researchAdrenal Crisis in a Delayed Diagnosis of Sheehan Syndrome.
CureusA Case of Sheehan Syndrome Six Years Postpartum Presented With Adrenal Crisis and Complicated by Hypothyroidism and Massive Pericardial Effusion.
CureusMyopathic syndrome revealing a rare condition: Sheehan syndrome, a case-based review.
Clinical rheumatologySheehan syndrome: Cardiovascular and metabolic comorbidities.
Frontiers in endocrinologyApproach to the Patient: A Case With an Unusual Cause of Hypopituitarism.
The Journal of clinical endocrinology and metabolismHigh prevalence of coronary artery calcification and increased risk for coronary artery disease in patients with Sheehan syndrome-A case-control study.
Clinical endocrinologyInflammatory Factor Levels and Clinical Characteristics of Mental Disorders in Patients with Sheehan Syndrome.
Alternative therapies in health and medicineSheehan syndrome presenting as acute renal failure: A rare case report from Somalia.
Annals of medicine and surgery (2012)Quality of life in Sheehan Syndrome.
Indian journal of endocrinology and metabolismMuscle biopsy of Sheehan Syndrome complicated with rhabdomyolysis.
Minerva medicaTransient Hepatitis Secondary to Zoledronic Acid in a Woman with Sheehan Syndrome.
Indian journal of endocrinology and metabolismA Rare Case of Sheehan Syndrome With Cardiac Tamponade.
CureusDHEA on Sexual Function in Sheehan Syndrome: A Randomized Double-Blind Placebo-Controlled Crossover Trial.
The Journal of clinical endocrinology and metabolismAcute Sheehan's syndrome manifesting initially with diabetes insipidus postpartum: a case report and systematic literature review.
Archives of gynecology and obstetricsSexual Dysfunction in Sheehan Syndrome.
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical EndocrinologistsA Case of Sheehan Syndrome 7 Years Postpartum with Transaminitis and Hyperlipidemia.
The American journal of case reportsSheehan Syndrome: An Unusual Presentation Without Inciting Factors.
Women's health reports (New Rochelle, N.Y.)Sheehan Syndrome Presenting with Psychotic Manifestations Mimicking Schizophrenia in a Young Female: A Case Report and Review of the Literature.
Case reports in endocrinologyCharacteristics of NAFLD Based on Hypopituitarism.
Canadian journal of gastroenterology & hepatologyUnmasking of Hypoparathyroidism by Zoledronic Acid Infusion in a Patient with Sheehan Syndrome.
Indian journal of endocrinology and metabolismTreatment-triggered onset and diagnosis of Sheehan syndrome in a multiple myeloma patient.
Cancer reports (Hoboken, N.J.)Spontaneous Conception, Pericardial Effusion, and Pseudohypertrophic Myopathy Mimicking Muscular Dystrophy in Delayed Presentation of Sheehan Syndrome.
Neurology IndiaAnesthetic management of a patient with Sheehan's syndrome and twin pregnancy while undergoing a cesarean section.
Journal of postgraduate medicineSheehan syndrome with Gitelman syndrome, Tackling Additive Morbidity.
Iranian journal of kidney diseasesHypopituitarism other than sellar and parasellar tumors or traumatic brain injury assessed in a tertiary hospital.
Pakistan journal of medical sciencesOther Pituitary Conditions and Pregnancy.
Endocrinology and metabolism clinics of North AmericaMULTIFACETED EVALUATION OF 72 PATIENTS WITH PITUITARY FAILURE.
Acta endocrinologica (Bucharest, Romania : 2005)EVALUATION OF TREATMENT OF CENTRAL HYPOTHYROIDISM VERSUS PRIMARY HYPOTHYROIDISM IN RELATION TO LEVOTHYROXINE REPLACEMENT DOSE.
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical EndocrinologistsPituitary Disorders in Pregnancy.
Neurologic clinicsSheehan syndrome mimicking dementia with Lewy bodies.
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical NeurophysiologySerum Lipid and Leptin Concentrations in Patients with Sheehan Syndrome.
Indian journal of endocrinology and metabolismRefractory Hypoglycemia and Seizures as the Initial Presenting Manifestation of Empty Sella Syndrome.
CureusExploring circulatory shock and mortality in viper envenomation: a prospective observational study from India.
QJM : monthly journal of the Association of PhysiciansAcute Sheehan Syndrome Manifesting as Unremitting Headache.
The NeurohospitalistDental status, salivary flow, and sociodemographic aspects in Sheehan Syndrome patients.
Medicina oral, patologia oral y cirugia bucalThyrotrophic status in patients with pituitary stalk interruption syndrome.
MedicineAcute pituitary disease in pregnancy: how to handle hypophysitis and Sheehan's syndrome.
Minerva endocrinologicaPractice Bulletin No. 183: Postpartum Hemorrhage.
Obstetrics and gynecologyPractice Bulletin No. 183 Summary: Postpartum Hemorrhage.
Obstetrics and gynecologyPitfall in the Diagnosis of Diabetes Insipidus and Pregnancy.
Case reports in obstetrics and gynecologyA case of acute Sheehan's syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage.
BMC pregnancy and childbirthRefractory hypotension induced by Sheehan syndrome with pituitary crisis: A case report.
Experimental and therapeutic medicinePsychosis as a late manifestation of Sheehan's syndrome.
Asian journal of psychiatryPsychiatric and Neurocognitive Manifestations of Sheehan Syndrome: A Case Report.
The primary care companion for CNS disorders[Atypical and rare cardiac revelation about Sheehan's syndrome: A report of three cases].
Annales de cardiologie et d'angeiologieImaging of Neurologic Conditions in Pregnant Patients.
Radiographics : a review publication of the Radiological Society of North America, IncCARDIAC STRUCTURAL AND FUNCTIONAL ABNORMALITIES IN FEMALES WITH UNTREATED HYPOPITUITARISM DUE TO SHEEHAN SYNDROME: RESPONSE TO HORMONE REPLACEMENT THERAPY.
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical EndocrinologistsChronic Sheehan syndrome presenting as pseudo-hypertrophic myopathy (Hoffman syndrome): A very rare combination.
Neurology India[Neurological Disorders and Pregnancy].
Fortschritte der Neurologie-PsychiatrieDemographic study of pituitary adenomas undergone trans-sphenoidal surgery in Loghman Hakim Hospital, Tehran, Iran 2001-2013.
Indian journal of endocrinology and metabolism[Nesidioblastosis in the adult: a case report].
Cirugia y cirujanosDiagnosis Delayed but not Denied - Sheehan's syndrome.
JNMA; journal of the Nepal Medical AssociationAssociações
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Total hip arthroplasty and perioperative management of a patient with hip osteonecrosis secondary to hypopituitarism due to Sheehan syndrome: a case report and literature review.
- Cytomegalovirus colitis in a woman with Sheehan syndrome.
- Complete Atrioventricular Block: An Exceedingly Rare Manifestation of Pituitary Crisis in Sheehan Syndrome.
- Recurrent Symptomatic Hyponatremia Revealing a Late Diagnosis of Sheehan Syndrome and Effectively Treated With Levothyroxine: A Case Report and Brief Review of Literature.
- Abnormal Blood Pressure Dipping Pattern in Women with Hypopituitarism Secondary to Sheehan Syndrome: A Case-Control Study.
- An overview of hypopituitarism's causes.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:91355(Orphanet)
- MONDO:0019618(MONDO)
- GARD:7630(GARD (NIH))
- Busca completa no PubMed(PubMed)
- Artigo Wikipedia(Wikipedia)
- Q535876(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
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