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Sheehan syndrome presenting as central diabetes insipidus: a rare presentation of an uncommon disorder.
MedLine Citation:
PMID:  21041172     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objective: To add to the current scant literature on rare clinical presentations of Sheehan syndrome.Methods: We describe the study patient's clinical, laboratory, and imaging findings and review the literature for publications regarding varied clinical presentations of Sheehan syndrome.Results: A 36-year-old multigravida woman developed severe postpartum hemorrhage and disseminated intravascular coagulation followed by Sheehan syndrome, with central diabetes insipidus as the primary presenting feature. This was diagnosed when, postoperatively, she developed polyuria with a urine output of 11 L in 24 hours with an accompanying rise in creatinine. She had laboratory evidence of diabetes insipidus, with serum osmolality greater than urine osmolality. Her clinical status improved significantly with intranasal desmopressin supplementation, thus confirming the diagnosis of Sheehan syndrome. Although Sheehan syndrome is a known complication of postpartum hemorrhage, central diabetes insipidus is seldom considered or suspected. Hypovolemia is usually presumed to be secondary to blood loss and polyuria resulting from a diuretic phase of acute renal failure.Conclusions: It is important to consider posterior pituitary ischemia resulting from Sheehan syndrome presenting as central diabetes insipidus as a cause of polyuria because appropriate hormonal replacement initiated early can possibly improve clinical status and patient outcomes.
Authors:
Saumya Kumar; Daryl Burrows; Shyam Dang; Debra Simmons
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  17     ISSN:  1934-2403     ISO Abbreviation:  Endocr Pract     Publication Date:    2011 Jan-Feb
Date Detail:
Created Date:  2011-02-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  108-14     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
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