Sheehan症候群の内分泌学的検討

The clinical history, laboratory data, and hypothalamic-pituitary-axis were investigated in 8 patients with Sheehan's syndrome. 2 patients had panhypopituitarism while 6 patients had selective pituitary deficiencies. Hypothalamic-pituitary-adrenal-axis in 2 patients with Sheehan's syndrome was impaired when the response to metopirone, but not to insulin-induced hypoglycemia. The interpretation of this difference is complicated in secondary hypothyroidism, and better preserved in the response to metopirone than to insulin-induced-hypoglycemia. The imbalance of LH and FSH response to LHRH in 2 cases (a blunted LH response in the presence of normal FSH response) may account for the complication of secondary hypothyroidism. The variety of Sheehan's syndrome was observed, for example that one case without history of postpartum hemorrhage or shock, and others with pregnancy after onset of Sheehan's syndrome. The duration of illness at the time of diagnosis ranged from 1.5 years to 11 years with an average of 6.5 years. In the future, a follow-up investigation of women with the history of postpartum hemorrhage or shock is necessary.