Skip to main content
SpringerLink
Log in

Hematological response of pancytopenia to glucocorticoids in patients with Sheehan’s syndrome

  • Published:
Pituitary Aims and scope Submit manuscript

Abstract

Sheehan’s syndrome presents with panhypopituitarism after childbirth, usually preceded by post partum hemorrhage. Hematological abnormalities like pancytopenia with hypocellular marrow in these patients are reported rarely. Though multiple hormone deficiencies may contribute to Pancytopenia in Sheehan’s syndrome, complete recovery is observed after achieving eucortisolemic and euthyroid state. The predominant role of thyroxine or glucocorticoids in reversing pancytopenia in these patients has not been studied. We present the clinical, hormonal, hematological course and response to glucocorticoids in a patient of Sheehan’s syndrome presenting with pancytopenia. Complete recovery of pancytopenia was observed after achieving eucortisolemic state thus concluding that gulcocorticoid replacement is sufficient to reverse pancytopenia in these patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Kelestimur F (2003) Sheehan’s syndrome. Pituitary 6:181–188

    Article  PubMed  Google Scholar 

  2. Zargar AH, Singh B, Laway BA, Masoodi SR, Wani AI, Bashir MI (2005) Epidemiological aspects of postpartum pituitary hypofunction (Sheehan’s syndrome). Fertil Steril 84:523–528

    Article  PubMed  Google Scholar 

  3. Gokalp D, Tuzcu A, Bahceci M, Arikan S, Bahceci S, Pasa S (2009) Sheehan’s syndrome as a rare cause of anaemia secondary to hypopituitarism. Ann Hematol 88:405–410

    Article  PubMed  Google Scholar 

  4. Laway BA, Mir SA, Bashir MI, Bhat JR, Samoon J, Zargar AH (2011) Prevalence of hematological abnormalities in patients with Sheehan’s syndrome: response to replacement of glucocorticoids and thyroxine. Pituitary 14:39–43

    Article  PubMed  CAS  Google Scholar 

  5. Laway BA, Bhat JR, Mir SA, Khan RSZ, Lone MI, Zargar AH (2010) Sheehan’s syndrome with pancytopenia: complete recovery after hormone replacement. Ann Hematol 89:305–308

    Article  PubMed  Google Scholar 

  6. Sheehan HL (1937) Postpartum necrosis of the anterior pituitary. J Pathol Bact 45:189–214

    Article  CAS  Google Scholar 

  7. Goswami R, Kochupillai N, Crock PA, Jaleel A, Gupta N (2002) Pituitary autoimmunity in patients with Sheehan’s syndrome. J Clin Endocrinol Metab 87:4137–4141

    Article  PubMed  CAS  Google Scholar 

  8. Zargar AH, Masoodi SR, Laway BA, Shah NA, Salahuddin M, Siddiqi MA (1996) Clinical spectrum of Sheehan’s syndrome. Ann Saudi Med 16:338–341

    PubMed  CAS  Google Scholar 

  9. Laway BA, Ganie MA, Butt TP, Zargar AH (2009) Multiple spontaneous pregnancies in Sheehan syndrome with preserved gonadotrophin function. The Endocrinologist 19:253–254

    Article  Google Scholar 

  10. Laway BA, Ganie MA, Bashir MI, Kotwal SK, Mir SA, Gojwari T, Zargar AH (2010) Sheehan’s syndrome with hyperprolactinemia. Turk JEM 14:47–49

    Google Scholar 

  11. Diederich S, Franzen NF, Bähr V, Oelkers W (2003) Severe hyponatremia due to hypopituitarism with adrenal insufficiency: report on 28 cases. Eur J Endocrinol 148:609–617

    Article  PubMed  CAS  Google Scholar 

  12. Oelkers W (1989) Hyponatremia and inappropriate secretion of vasopressin (antidiuretic hormone) in patients with hypopituitarism. N Engl J Med 321:492–496

    Article  PubMed  CAS  Google Scholar 

  13. Foppiani L, Ruelle A, Quilici P, Del Monte P (2009) Hypopituitarism in the elderly: two case-reports with heterogeneous presentation. Aging Clin Exp Res 21:76–81

    PubMed  Google Scholar 

  14. Peschle C, Rappaport IA, Magli MC, Marone G, Lettieri F, Cillo C, Gordon AS (1978) Role of hypophysis in erythropoietin production during hypoxia. Blood 51:1117–1124

    PubMed  CAS  Google Scholar 

  15. Golde DW, Bersch N, Cline MJ (1976) Potentation of erythropoiesis in vitro by dexamethasone. J Clin Invest 57:57–62

    Article  PubMed  CAS  Google Scholar 

  16. Godle DW, Bersch N, Chopra IJ, Cline MJ (1977) Thyroid hormones stimulate erythropoiesis in vitro. Br J Haematol 37:173–177

    Article  Google Scholar 

  17. Song SH, McCallum CJ, Campbell IW (1998) Hypoplastic anaemia complicating myxedema. Scott Med J 43:149–150

    PubMed  CAS  Google Scholar 

  18. Lee AC (2010) Pancytopenia due to hypopituitarism may just be due to hypothyroidism alone. Ann Hematol 89:1181

    Article  PubMed  Google Scholar 

  19. Brent GA, Larsen PR (2000) Treatment of hypothyroidism. In: Braverman LE, Utiger RD (eds) Werner and Ingbar’s the thyroid: a fundamental and clinical text, 8th edn. Lippincott Williams and Wilkins, Philadelphia, pp 853–860

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Endocrinology, Sher-I- Kashmir Institute of Medical Sciences Soura, Srinagar, Jammu and Kashmir, India

    Bashir Ahmad Laway, Shahnaz Ahmad Mir & Abdul Hamid Zargar

  2. Department of Clinical Hematology, Sher-I- Kashmir Institute of Medical Sciences Soura, Srinagar, Jammu and Kashmir, India

    Javid Rasool Bhat & Jeelani Samoon

  3. Department of Pathology, Sher-I- Kashmir Institute of Medical Sciences Soura, Srinagar, Jammu and Kashmir, India

    Mohd Iqbal Lone

Authors
  1. Bashir Ahmad Laway
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shahnaz Ahmad Mir
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Javid Rasool Bhat
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mohd Iqbal Lone
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jeelani Samoon
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Abdul Hamid Zargar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Abdul Hamid Zargar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Laway, B.A., Mir, S.A., Bhat, J.R. et al. Hematological response of pancytopenia to glucocorticoids in patients with Sheehan’s syndrome. Pituitary 15, 184–187 (2012). https://doi.org/10.1007/s11102-011-0304-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11102-011-0304-5

Keywords

Search

Navigation