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Rare disease
Acute Sheehan's syndrome presenting as central diabetes insipidus
  1. Raquel Robalo1,
  2. Célia Pedroso1,
  3. Ana Agapito2,
  4. Augusta Borges3
  1. 1Department of Maternal and Fetal Medicine, Maternidade Alfredo da Costa, Centro Hospitalar Lisboa Central, Lisboa, Portugal
  2. 2Department of Endocrinology, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Lisboa, Portugal
  3. 3Department of Internal Medicine, Maternidade Alfredo da Costa, Centro Hospitalar Lisboa Central, Lisboa, Portugal
  1. Correspondence to Dr Raquel Robalo, raquelrobalof{at}gmail.com

Summary

Sheehan's syndrome occurs as a result of ischaemic pituitary necrosis due to severe postpartum haemorrhage. Improvements in obstetrical care have significantly reduced its incidence in developed countries, but postpartum pituitary infarction remains a common cause of hypopituitarism in developing countries. We report a case of severe postpartum haemorrhage followed by headache, central diabetes insipidus and failure to lactate, which prompted us to investigate and identify both anterior and posterior pituitary deficiency compatible with Sheehan's syndrome. A timely diagnosis allowed us to implement an adequate treatment and follow-up plan, which are known to improve clinical status and patient outcome.

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