PDF(Pubmed)
Abstract：
Sheehan\'s syndrome is a well-recognized cause of panhypopituitarism secondary to pituitary apoplexy, followed by postpartum hemorrhage. Depending upon the degree of ischemic injury, it can be either partial or complete.
UNASSIGNED: We report an interesting case of a 35-year-old woman admitted to our hospital with complaints of abdominal distension, which was later presumed to be due to disseminated tuberculosis (TB) after excluding the possible differentials. During the treatment course, she was going through repeated attacks of hypovolemic shock and hypoglycemia due to adrenocortical insufficiency. This, along with the history of prolonged amenorrhea 4 years back due to severe postpartum hemorrhage in her last pregnancy, has led us to our diagnosis of partial Sheehan\'s syndrome. After 1 month of starting steroid and anti-TB therapy, it was quite surprising when she presented with features of pancytopenia and antitubercular drug-induced hepatitis.
UNASSIGNED: Sheehan\'s syndrome may have a varying degree of presentation depending upon the degree of damage to the pituitary gland, which includes amenorrhea, lactation failure, adrenocortical insufficiency, hyponatremia, hypoglycemia, as well as pancytopenia in some rare instances The hormone panel especially the thyroid profile should be monitored carefully. Such cases are often challenging to deal with because of their varying degrees of presentation and the delay in diagnosis due to a lack of clinical suspicion.
UNASSIGNED: Therefore, we believe that this rare presentation of pancytopenia in Sheehan\'s syndrome with fluctuating thyroid profile and abdominal TB in the background will let clinicians approach such a rare disease differently.
UNASSIGNED: We report an interesting case of a 35-year-old woman admitted to our hospital with complaints of abdominal distension, which was later presumed to be due to disseminated tuberculosis (TB) after excluding the possible differentials. During the treatment course, she was going through repeated attacks of hypovolemic shock and hypoglycemia due to adrenocortical insufficiency. This, along with the history of prolonged amenorrhea 4 years back due to severe postpartum hemorrhage in her last pregnancy, has led us to our diagnosis of partial Sheehan\'s syndrome. After 1 month of starting steroid and anti-TB therapy, it was quite surprising when she presented with features of pancytopenia and antitubercular drug-induced hepatitis.
UNASSIGNED: Sheehan\'s syndrome may have a varying degree of presentation depending upon the degree of damage to the pituitary gland, which includes amenorrhea, lactation failure, adrenocortical insufficiency, hyponatremia, hypoglycemia, as well as pancytopenia in some rare instances The hormone panel especially the thyroid profile should be monitored carefully. Such cases are often challenging to deal with because of their varying degrees of presentation and the delay in diagnosis due to a lack of clinical suspicion.
UNASSIGNED: Therefore, we believe that this rare presentation of pancytopenia in Sheehan\'s syndrome with fluctuating thyroid profile and abdominal TB in the background will let clinicians approach such a rare disease differently.
摘要：
Sheehan综合征是垂体卒中继发的垂体功能减退的公认原因，其次是产后出血。根据缺血性损伤的程度，它可以是部分的，也可以是完整的。
未经调查：我们报告了一个有趣的病例，一名35岁的妇女因腹胀而入院，在排除可能的差异后，后来被认为是由于播散性结核病（TB）。在治疗过程中，她因肾上腺皮质功能不全而反复出现低血容量性休克和低血糖.这个,加上4年前因上次怀孕严重产后出血而长期闭经的病史，导致我们诊断出部分希汉综合征。开始类固醇和抗结核治疗1个月后，当她表现出全血细胞减少症和抗结核药物性肝炎的特征时，这是相当令人惊讶的。
未经证实：希汉综合征可能有不同程度的表现，这取决于垂体的损伤程度，包括闭经，泌乳失败,肾上腺皮质功能不全,低钠血症,低血糖,以及在一些罕见的情况下全血细胞减少应仔细监测激素组，尤其是甲状腺的情况。此类病例由于其不同程度的表现以及由于缺乏临床怀疑而导致的诊断延迟，因此通常难以处理。
UNASSIGNED：因此，我们认为,在甲状腺结构波动的Sheehan综合征和腹部结核的背景下,这种罕见的全血细胞减少症的表现将使临床医生对这种罕见的疾病有不同的认识.
未经调查：我们报告了一个有趣的病例，一名35岁的妇女因腹胀而入院，在排除可能的差异后，后来被认为是由于播散性结核病（TB）。在治疗过程中，她因肾上腺皮质功能不全而反复出现低血容量性休克和低血糖.这个,加上4年前因上次怀孕严重产后出血而长期闭经的病史，导致我们诊断出部分希汉综合征。开始类固醇和抗结核治疗1个月后，当她表现出全血细胞减少症和抗结核药物性肝炎的特征时，这是相当令人惊讶的。
未经证实：希汉综合征可能有不同程度的表现，这取决于垂体的损伤程度，包括闭经，泌乳失败,肾上腺皮质功能不全,低钠血症,低血糖,以及在一些罕见的情况下全血细胞减少应仔细监测激素组，尤其是甲状腺的情况。此类病例由于其不同程度的表现以及由于缺乏临床怀疑而导致的诊断延迟，因此通常难以处理。
UNASSIGNED：因此，我们认为,在甲状腺结构波动的Sheehan综合征和腹部结核的背景下,这种罕见的全血细胞减少症的表现将使临床医生对这种罕见的疾病有不同的认识.
