Sheehan’s Syndrome Revisited: Underlying Autoimmunity or Hypoperfusion?

González González, José Gerardo y Borjas Almaguer, Omar David y Salcido Montenegro, Alejandro y Rodríguez Guajardo, René y Elizondo Plazas, Anasofia y Montes de Oca Luna, Roberto y Rodríguez Gutiérrez, René (2018) Sheehan’s Syndrome Revisited: Underlying Autoimmunity or Hypoperfusion? International Journal of Endocrinology, 2018. pp. 1-8. ISSN 1687-8337

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Resumen

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.

Tipo de elemento:	Article
Divisiones:	Medicina
Usuario depositante:	Lic. Josimar Pulido
Creadores:	Creador Email ORCID González González, José Gerardo gerardo.gonzalezgzz@uanl.edu.mx orcid.org/0000-0002-6609-9483 Borjas Almaguer, Omar David NO ESPECIFICADO NO ESPECIFICADO Salcido Montenegro, Alejandro NO ESPECIFICADO NO ESPECIFICADO Rodríguez Guajardo, René NO ESPECIFICADO NO ESPECIFICADO Elizondo Plazas, Anasofia NO ESPECIFICADO NO ESPECIFICADO Montes de Oca Luna, Roberto NO ESPECIFICADO NO ESPECIFICADO Rodríguez Gutiérrez, René NO ESPECIFICADO NO ESPECIFICADO
Fecha del depósito:	30 Ago 2019 20:06
Última modificación:	11 Dic 2024 14:34
URI:	http://eprints.uanl.mx/id/eprint/16599

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