Major depressive disorder secondary to Sheehan syndrome, late diagnosis
DOI:
https://doi.org/10.18041/2665-427X/ijeph.1.10212Keywords:
Sheehan syndrome, panhypopituitarism, postpartum hemorrhage, depressive disorderAbstract
Introduction: Sheehan syndrome (SS) or pituitary gland infarction is a cause of panhypopituitarism secondary to postpartum uterine hemorrhage that produces necrosis of the pituitary gland. Its clinical manifestations are non-specific and can occur several months or years after delivery. The most common initial symptoms are agalactia and/or amenorrhea; in some cases, they may present psychiatric symptoms, of which 32% correspond to major depression.
Case presentation: Patient with a history of major depressive disorder, suicidal ideation, and attempts, with a temporal relationship of onset of symptoms after postpartum hemorrhage 30 years ago, accompanied by agalactia and oligomenorrhea in the postpartum. Consultation due to chronic fatigue, generalized muscle pain, asthenia and adynamic accompanied by breast atrophy and loss of facial hair. Central hypothyroidism and laboratory and imaging studies compatible with panhypopituitarism and empty sella syndrome are documented. The patient was considered to have Sheehan's syndrome, and antidepressant treatment, cognitive behavioral therapy, and hormonal replacement were initiated, with improvement in constitutional and depressive symptoms.
Conclusion: Panhypopituitarism secondary to Sheehan syndrome is part of the secondary etiologies of affective disorders in patients with an obstetric history, the importance of timely diagnosis and treatment is emphasized
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