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 2017,...
| Autores principales: | , , , , , , |
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| Formato: | Artículo |
| Lenguaje: | inglés |
| Publicado: |
2018
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| Acceso en línea: | http://eprints.uanl.mx/16599/1/208.pdf |
| _version_ | 1824414654341840896 |
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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 | Repositorio Institucional |
| 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 | Article |
| id | eprints-16599 |
| institution | UANL |
| language | English |
| publishDate | 2018 |
| record_format | eprints |
| spelling | eprints-165992024-12-11T14:34:06Z http://eprints.uanl.mx/16599/ 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 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. 2018-02-28 Article PeerReviewed text en cc_by_nc_nd http://eprints.uanl.mx/16599/1/208.pdf http://eprints.uanl.mx/16599/1.haspreviewThumbnailVersion/208.pdf 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 http://doi.org/10.1155/2018/8415860 doi:10.1155/2018/8415860 |
| spellingShingle | 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? |
| thumbnail | https://rediab.uanl.mx/themes/sandal5/images/online.png |
| 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 |
| url | http://eprints.uanl.mx/16599/1/208.pdf |
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