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Case Report

Published: Nov 30, 2025 | DOI: 10.24911/ejmcr.9-2393

Late Diagnosis of Sheehan Syndrome – A case report.

Authors: Daniel Santos Rodrigues , Beatriz Rosa , Carolina Oliveira , Laura Caine , Elsa Goncalves , Carla Lemos Costa

Article Info

Authors

Daniel Santos Rodrigues

Internal Medicine Department, Barcelos-Esposende Local Health Unit, Barcelos, Portugal

ORCID

Beatriz Rosa

Internal Medicine Department, Barcelos-Esposende Local Health Unit, Barcelos, Portugal

Carolina Oliveira

Internal Medicine Department, Barcelos-Esposende Local Health Unit, Barcelos, Portugal

Laura Caine

Internal Medicine Department, Barcelos-Esposende Local Health Unit, Barcelos, Portugal

Elsa Goncalves

Internal Medicine Department, Barcelos-Esposende Local Health Unit, Barcelos, Portugal

Carla Lemos Costa

Internal Medicine Department, Barcelos-Esposende Local Health Unit, Barcelos, Portugal

Publication History

Received: October 18, 2025

Accepted: November 14, 2025

Published: November 30, 2025

Abstract

Background: Sheehan’s syndrome (SS) is a rare but serious complication of severe postpartum hemorrhage, primarily resulting from ischemic necrosis of the anterior pituitary gland. It leads to varying degrees of hypopituitarism and presents with a broad spectrum of clinical manifestations. Early features typically include agalactia due to prolactin deficiency and persistent amenorrhea. As the condition progresses, patients may develop nonspecific symptoms such as asthenia, fatigue, headache, and pallor. Diagnosis is made by a triad of clinical manifestations, biochemical findings, and imaging.

Case presentation: This report describes the case of a 63-year-old woman presenting with generalized weakness and drowsiness. Laboratory evaluation revealed hyponatremia, hypoglycemia, hypocortisolism, and secondary hypothyroidism. Magnetic resonance imaging demonstrated a partially empty sella.

Conclusion: The average delay in diagnosis of SS has been estimated at nearly two decades, likely due to the high prevalence of vague and nonspecific symptoms in affected women. Increased clinical awareness is essential to improve outcomes and prevent long-term complications associated with this condition. This case underscores that SS can present decades after delivery and that timely hormone replacement is lifesaving.

Keywords: Sheehan’s syndrome; Postpartum pituitary necrosis; Hypopituitarism; Empty sella; Secondary hypothyroidism.

Pubmed Style

Daniel Santos Rodrigues, Beatriz Rosa, Carolina Oliveira, Laura Caine, Elsa Goncalves, Carla Lemos Costa. Late Diagnosis of Sheehan Syndrome – A case report.. EJMCR. 2025; 30 (November 2025): -. doi:10.24911/ejmcr.9-2393

Web Style

Daniel Santos Rodrigues, Beatriz Rosa, Carolina Oliveira, Laura Caine, Elsa Goncalves, Carla Lemos Costa. Late Diagnosis of Sheehan Syndrome – A case report.. https://ejmcr.com/articles/2393 [Access: November 30, 2025]. doi:10.24911/ejmcr.9-2393

AMA (American Medical Association) Style

Vancouver/ICMJE Style

Daniel Santos Rodrigues, Beatriz Rosa, Carolina Oliveira, Laura Caine, Elsa Goncalves, Carla Lemos Costa. Late Diagnosis of Sheehan Syndrome – A case report.. EJMCR. (2025), [cited November 30, 2025]; 30 (November 2025): -. doi:10.24911/ejmcr.9-2393

Harvard Style

Daniel Santos Rodrigues, Beatriz Rosa, Carolina Oliveira, Laura Caine, Elsa Goncalves, Carla Lemos Costa (2025) Late Diagnosis of Sheehan Syndrome – A case report.. EJMCR, 30 (November 2025): -. doi:10.24911/ejmcr.9-2393

Chicago Style

Daniel Santos Rodrigues, Beatriz Rosa, Carolina Oliveira, Laura Caine, Elsa Goncalves, Carla Lemos Costa. "Late Diagnosis of Sheehan Syndrome – A case report.." 30 (2025), -. doi:10.24911/ejmcr.9-2393

MLA (The Modern Language Association) Style

Daniel Santos Rodrigues, Beatriz Rosa, Carolina Oliveira, Laura Caine, Elsa Goncalves, Carla Lemos Costa. "Late Diagnosis of Sheehan Syndrome – A case report.." 30.November 2025 (2025), -. Print. doi:10.24911/ejmcr.9-2393

APA (American Psychological Association) Style

Daniel Santos Rodrigues, Beatriz Rosa, Carolina Oliveira, Laura Caine, Elsa Goncalves, Carla Lemos Costa (2025) Late Diagnosis of Sheehan Syndrome – A case report.. , 30 (November 2025), -. doi:10.24911/ejmcr.9-2393