PT - JOURNAL ARTICLE AU - Abdul Majid Wani AU - Waleed Mohd Hussain AU - Mousa Ali Al Mejally AU - Abdulhakeem Amroon Banjar AU - Khaled Shawkat Ali AU - Amer Mohd Khoujah AU - Sadeya Hanif Raja AU - Mazen G Bafaraj AU - Wail Al Miamini AU - Mubeena Akhtar TI - Practice of symptomatic treatment in the era of evidence-based medicine: report of 2 cases of diagnosis of Sheehan’s syndrome delayed till eighth decade AID - 10.1136/bcr.09.2009.2276 DP - 2010 Jan 01 TA - BMJ Case Reports PG - bcr0920092276 VI - 2010 4099 - http://casereports.bmj.com/content/2010/bcr.09.2009.2276.short 4100 - http://casereports.bmj.com/content/2010/bcr.09.2009.2276.full AB - Sheehan’s syndrome, first described in 1937, is characterised by postpartum haemorrhage, pituitary necrosis, lactational failure and hypopitutarism. Presentation is variable and late presentations are not unusual due to partial ischaemic injury of the pituitary and gradual loss of endocrine function. A history of postpartum haemorrhage is usual but in some cases it is not elicited. Presentations such as malaise, fatigue, hypoglycaemia, decline in cognition, hyponatraemia, pancytopoenia, osteoporosis, secondary infertility, confusion and coma have all been reported. Two interesting cases of Sheehan’s syndrome are presented that were diagnosed in the eighth decade; one due to atypical presentation of recurrent hyponatraemia and confusion, another from hypoglycaemic coma and symptoms of malaise and lethargy.