{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T13:00:24Z","timestamp":1777726824743,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"the State Key Laboratory of Wet Evidence in Traditional Chinese Medicine jointly established by the Ministry of Provincial Affairs","award":["No. SZ2021ZZ3203"],"award-info":[{"award-number":["No. SZ2021ZZ3203"]}]},{"name":"Guangdong Provincial Hospital of Traditional Chinese Medicine Famous Chinese Medicine Experts Inheritance Workshop: Lu Zhizheng Famous Doctor's Workshop","award":["No. E43710"],"award-info":[{"award-number":["No. E43710"]}]},{"name":"the Training Program for Young and Middle-aged Key Physicians of Yunnan Province","award":["Yunwei Renfa [2024] No. 5"],"award-info":[{"award-number":["Yunwei Renfa [2024] No. 5"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>Sheehan\u2019s syndrome is a disorder caused by ischemic necrosis of the pituitary gland following postpartum hemorrhage, typically resulting in pituitary dysfunction that can affect the adrenal, thyroid, and gonadal axes. Clinically, patients may present with dysfunction of a single axis or multiple axes. The co-occurrence of Sheehan\u2019s syndrome and Graves\u2019 disease is extremely rare, posing a significant diagnostic challenge. Herein, we report the case of a woman in her early 50s with a 28-year history of Sheehan\u2019s syndrome, which had led to complete pituitary dysfunction, who had been managing hypothyroidism for the past 20 years. However, over a 6-month period, she developed chronic diarrhea and showed progressive weight loss and laboratory results indicating hyperthyroidism. Based on further imaging and laboratory findings, along with her medical history, a diagnosis of Sheehan\u2019s syndrome complicated with Graves\u2019 disease was established, as evidenced by elevated levels of thyrotropin receptor antibodies. Treatment included adrenocorticotropic hormone replacement, antithyroid therapy, and other supportive measures. Although her gastrointestinal symptoms and weight loss resolved initially, the patient continued to experience persistent hyperthyroidism and elevated thyrotropin receptor antibody levels at the 20-month follow-up. This case highlights the need for regular endocrine monitoring in patients with Sheehan\u2019s syndrome, particularly those with long-standing hypothyroidism, to promptly identify and address the potential overlap of autoimmune thyroid diseases.<\/jats:p>","DOI":"10.1177\/03000605251363777","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T12:30:43Z","timestamp":1754483443000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Sheehan\u2019s syndrome complicated with Graves\u2019 disease in a woman with a 20-year history of hypothyroidism"],"prefix":"10.1177","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3828-4490","authenticated-orcid":false,"given":"ManLi","family":"Yan","sequence":"first","affiliation":[{"name":"The Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingyun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Wenshan Zhuang and Miao Autonomous Prefecture Hospital of Traditional Chinese Medicine, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiting","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hua","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, China"},{"name":"State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"e_1_3_9_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2013-201554"},{"key":"e_1_3_9_3_2","first-page":"9181365","article-title":"Acute Sheehan\u2019s syndrome presenting with hyponatremia followed by a spontaneous pregnancy","volume":"2022","author":"Pineyro MM","year":"2022","unstructured":"Pineyro MM, Diaz L, Guzzetti M, et\u00a0al. Acute Sheehan\u2019s syndrome presenting with hyponatremia followed by a spontaneous pregnancy. Case Rep Endocrinol 2022; 2022: 9181365.","journal-title":"Case Rep Endocrinol"},{"key":"e_1_3_9_4_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1117"},{"key":"e_1_3_9_5_2","doi-asserted-by":"publisher","DOI":"10.1210\/en.2015-1741"},{"key":"e_1_3_9_6_2","doi-asserted-by":"publisher","DOI":"10.1210\/en.2012-1152"},{"key":"e_1_3_9_7_2","doi-asserted-by":"publisher","DOI":"10.2217\/rme.14.19"},{"key":"e_1_3_9_8_2","first-page":"255","article-title":"Hyperthyroidism and hypopituitarism: two incompatible diagnoses?","volume":"110","author":"Bertola G","year":"2019","unstructured":"Bertola G, Bianchi R, Giambona S, et\u00a0al. Hyperthyroidism and hypopituitarism: two incompatible diagnoses? Recenti Prog Med 2019; 110: 255\u2013258.","journal-title":"Recenti Prog Med"},{"key":"e_1_3_9_9_2","doi-asserted-by":"publisher","DOI":"10.4103\/1119-3077.141447"},{"key":"e_1_3_9_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.1804"},{"key":"e_1_3_9_11_2","doi-asserted-by":"publisher","DOI":"10.3803\/EnM.2023.1785"},{"key":"e_1_3_9_12_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.00601"},{"key":"e_1_3_9_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-87126-0"},{"key":"e_1_3_9_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2025.110938"},{"key":"e_1_3_9_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2018.00312"}],"container-title":["Journal of International Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605251363777","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03000605251363777","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605251363777","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:47:54Z","timestamp":1777459674000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03000605251363777"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":14,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1177\/03000605251363777"],"URL":"https:\/\/doi.org\/10.1177\/03000605251363777","relation":{},"ISSN":["0300-0605","1473-2300"],"issn-type":[{"value":"0300-0605","type":"print"},{"value":"1473-2300","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"article-number":"03000605251363777"}}