Zusammenfassung
Das Sheehan Syndrom – eine ischämische Nekrose des Hypophysenvorderlappens, verursacht durch schweren Blutverlust im Rahmen der Geburt – stellt in der westlichen Welt im Vergleich zu Entwicklungsländern eine seltene Ursache für Panhypopituitarismus dar. Im Rahmen der Abklärung einer schwerern Anämie und Müdigkeit wurde bei einem 45jährigen Kriegsflüchtling aus Tschetschenien an unserer Klinik ein Sheehan Syndrom diagnostiziert, 15 Jahre nach einer schweren postpartalen Blutung mit nachfolgender Hysterektomie. Der daraus resultierende Panhypopituitarismus wurde mittels Thyroxin, Hydrocortison und transdermalem Östrogen substituiert und die Symptomatik als auch die Anämie besserten sich umgehend. Die essentielle Bedeutung der Endokrinologie für die Erythropoiese wird durch die schwere Anämie auf Grund des Panhypopituitarismus verdeutlicht. Den Hormonen der Schilddrüse kommt der basiswissenschaftlichen als auch der klinischen Forschung zufolge wohl die größte Bedeutung zu.
Summary
Ischemic pituitary necrosis due to severe postpartum haemorrhage called Sheehan's syndrome is a rare cause of hypopituitarism in the western world, but much more common in developing countries. A 45-year-old female patient being a war refugee from Chechnya with severe anaemia and fatigue was diagnosed at our outpatient department with Sheehan's syndrome after severe postpartum haemorrhage and emergency hysterectomy 15 years ago. Panhypopituitarism was adequately treated with substitution of hydrocortisone, thyroxine and transdermal oestrogen which resulted in haemoglobin increase to nearly normal levels and symptoms improved immediately. Severe anaemia caused by panhypopituitarism shows the importance of the hormonal system for erythropoiesis. Clinical and basic scientific evidence indicates thyroidal hormones to be the main cause.
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Melchardt, T., Namberger, K., Weiss, L. et al. An uncommon cause of anaemia: Sheehan's syndrome. Wien Klin Wochenschr 122, 717–719 (2010). https://doi.org/10.1007/s00508-010-1480-4
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DOI: https://doi.org/10.1007/s00508-010-1480-4