A 21-year-old woman experiences abruptio placentae with severe bleeding during the delivery of a term fetus. Five months later, she presents with profound lethargy, pallor, muscle weakness, failure of lactation and amenorrhea. Which of the following pathologic findings is expected in this patient?
Atrophy of the endocrine pancreas
Autoimmune destruction of the adrenal coex
Infarction of the pituitary
Pituitary prolactinoma
- Given clinical features suggests the diagnosis of Sheehan syndrome. SHEEHAN SYNDROME - Caused d/t postpaum ischemic necrosis of anterior pituitary. - Occurs after severe hypotension induced by postpaum hemorrhage. - The pituitary is paicularly susceptible at this time because its enlargement during pregnancy renders it vulnerable to reduction in blood flow. - C/F of panhypopituitarism : Pallor (d/t decreased MSH) Hypothyroidism (d/t decreased TSH) Failure of lactation (d/t decreased prolactin) Adrenal insufficiency (d/t decreased ACTH) Ovarian failure (d/t decreased FSH and LH). - None of the other choices lead to this constellation of hormone deficiencies.
Miscellaneous