{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T01:43:26Z","timestamp":1771379006379,"version":"3.50.1"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Endocr Disord"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Sheehan\u2019s syndrome is a rare condition, which is classically characterized by anterior pituitary hypofunction following postpartum shock or hemorrhage. While diabetes insipidus (DI) is not commonly associated with Sheehan\u2019s syndrome, we present a rare case of a multiparous female developing rapid-onset panhypopituitarism and DI following severe postpartum hemorrhage.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A previously healthy 39-year-old woman, gravida 5, para 4, presented with hypovolemic shock after vaginal delivery, attributed to severe postpartum hemorrhage, necessitating emergent hysterectomy. Although her shock episodes resolved during hospitalization, she developed intermittent fever, later diagnosed as adrenal insufficiency. Administration of hydrocortisone effectively resolved the fever. However, she subsequently developed diabetes insipidus. Diagnosis of Sheehan\u2019s syndrome with central diabetes insipidus was confirmed through functional hormonal tests and MRI findings. Treatment consisted of hormone replacement therapy, with persistent panhypopituitarism noted during a ten-year follow-up period.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Sheehan\u2019s syndrome is a rare complication of postpartum hemorrhage. Central diabetes insipidus should be suspected, although not commonly, while the patient presented polyuria and polydipsia. Besides, the potential necessity for long-term hormonal replacement therapy should be considered.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12902-024-01654-w","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T04:01:34Z","timestamp":1721707294000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Sheehan\u2019s syndrome presenting with panhypopituitarism and central diabetes insipidus: a case report"],"prefix":"10.1186","volume":"24","author":[{"given":"Chin-Fang","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Cheng","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng-Jie","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Horng-Yih","family":"Ou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,23]]},"reference":[{"key":"1654_CR1","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1002\/path.1700850115","volume":"85","author":"HL Sheehan","year":"1963","unstructured":"Sheehan HL, Whitehead R. The neurohypophysis in post-partum hypopituitarism. J Pathol Bacteriol. 1963;85:145\u201369.","journal-title":"J Pathol Bacteriol"},{"issue":"1","key":"1654_CR2","doi-asserted-by":"publisher","first-page":"108","DOI":"10.4158\/EP10015.CR","volume":"17","author":"S Kumar","year":"2011","unstructured":"Kumar S, Burrows D, Dang S, Simmons D. Sheehan syndrome presenting as central diabetes insipidus: a rare presentation of an uncommon disorder. Endocr Pract. 2011;17(1):108\u201314.","journal-title":"Endocr Pract"},{"issue":"3","key":"1654_CR3","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1210\/jcem-68-3-560","volume":"68","author":"Y Iwasaki","year":"1989","unstructured":"Iwasaki Y, Oiso Y, Yamauchi K, Takatsuki K, Kondo K, Hasegawa H, et al. Neurohypophyseal function in postpartum hypopituitarism: impaired plasma vasopressin response to osmotic stimuli. J Clin Endocrinol Metab. 1989;68(3):560\u20135.","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"1654_CR4","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1210\/jcem-58-3-511","volume":"58","author":"F Bakiri","year":"1984","unstructured":"Bakiri F, Benmiloud M, Vallotton MB. Arginine-vasopressin in postpartum panhypopituitarism: urinary excretion and kidney response to osmolar load. J Clin Endocrinol Metab. 1984;58(3):511\u20135.","journal-title":"J Clin Endocrinol Metab"},{"issue":"6445","key":"1654_CR5","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1136\/bmj.289.6445.579","volume":"289","author":"F Bakiri","year":"1984","unstructured":"Bakiri F, Benmiloud M. Antidiuretic function in Sheehan\u2019s syndrome. Br Med J (Clin Res Ed). 1984;289(6445):579\u201380.","journal-title":"Br Med J (Clin Res Ed)"},{"issue":"1","key":"1654_CR6","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1111\/j.1365-2265.1987.tb00843.x","volume":"27","author":"I Jialal","year":"1987","unstructured":"Jialal I, Desai RK, Rajput MC. An assessment of posterior pituitary function in patients with Sheehan\u2019s syndrome. Clin Endocrinol (Oxf). 1987;27(1):91\u20135.","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"6","key":"1654_CR7","first-page":"494","volume":"127","author":"MA Arnaout","year":"1992","unstructured":"Arnaout MA, Ajlouni K. Plasma vasopressin responses in postpartum hypopituitarism: impaired response to osmotic stimuli. Acta Endocrinol (Copenh). 1992;127(6):494\u20138.","journal-title":"Acta Endocrinol (Copenh)"},{"issue":"5","key":"1654_CR8","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1530\/EJE-06-0727","volume":"156","author":"H Atmaca","year":"2007","unstructured":"Atmaca H, Tanriverdi F, Gokce C, Unluhizarci K, Kelestimur F. Posterior pituitary function in Sheehan\u2019s syndrome. Eur J Endocrinol. 2007;156(5):563\u20137.","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"1654_CR9","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1016\/S0015-0282(16)48926-0","volume":"44","author":"RL Barbieri","year":"1985","unstructured":"Barbieri RL, Randall RW, Saltzman DH. Diabetes insipidus occurring in a patient with Sheehan\u2019s syndrome during a gonadotropin-induced pregnancy. Fertil Steril. 1985;44(4):529\u201331.","journal-title":"Fertil Steril"},{"issue":"3","key":"1654_CR10","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1007\/s00404-021-06294-2","volume":"306","author":"GL Olmes","year":"2022","unstructured":"Olmes GL, Solomayer EF, Radosa JC, Sklavounos P, Agne P, Schunk SJ, et al. Acute Sheehan\u2019s syndrome manifesting initially with diabetes insipidus postpartum: a case report and systematic literature review. Arch Gynecol Obstet. 2022;306(3):699\u2013706.","journal-title":"Arch Gynecol Obstet"},{"issue":"07","key":"1654_CR11","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1055\/s-2007-1022724","volume":"58","author":"W Kuhn","year":"1998","unstructured":"Kuhn W, Krau\u00df T. Das Sheehan-Syndrom, eine fast vergessene schwere komplikation post partum. Geburtshilfe Frauenheilkd. 1998;58(07):336\u201342.","journal-title":"Geburtshilfe Frauenheilkd"},{"issue":"3","key":"1654_CR12","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1046\/j.1365-2796.1998.00370.x","volume":"244","author":"S Dejager","year":"1998","unstructured":"Dejager S, Gerber S, Foubert L, Turpin G. Sheehan\u2019s syndrome: differential diagnosis in the acute phase. J Intern Med. 1998;244(3):261\u20136.","journal-title":"J Intern Med"},{"issue":"2","key":"1654_CR13","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1111\/j.1479-828X.1998.tb03009.x","volume":"38","author":"AK Kan","year":"1998","unstructured":"Kan AK, Calligerous D. A case report of Sheehan syndrome presenting with diabetes insipidus. Aust N Z J Obstet Gynaecol. 1998;38(2):224\u20136.","journal-title":"Aust N Z J Obstet Gynaecol"},{"issue":"6","key":"1654_CR14","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1081\/JDI-120015686","volume":"24","author":"HY Wang","year":"2002","unstructured":"Wang HY, Chang CT, Wu MS. Postpartum hemorrhage complicated with irreversible renal failure and central diabetes insipidus. Ren Fail. 2002;24(6):849\u201352.","journal-title":"Ren Fail"},{"key":"1654_CR15","doi-asserted-by":"crossref","unstructured":"Catinois ML, Chabre O, Chirossel C, Pellat J-M. Payen j-f. Le syndrome de Sheehan: un diagnostic difficile en post-partum imm\u00e9diat. Annales Fran\u00e7aises d\u2019Anesth\u00e9sie et de R\u00e9animation. 2004;23:508\u201312.","DOI":"10.1016\/j.annfar.2004.01.016"},{"key":"1654_CR16","doi-asserted-by":"crossref","unstructured":"Robalo R, Pedroso C, Agapito A, Borges A. Acute Sheehan\u2019s syndrome presenting as central diabetes insipidus. BMJ Case Rep. 2012;2012.","DOI":"10.1136\/bcr-2012-007022"},{"key":"1654_CR17","doi-asserted-by":"crossref","unstructured":"Rahmani Tzvi-Ran I, Olchowski J, Fraenkel M, Bashiri A, Barski L. A rare cause of postpartum acute hyponatremia. Endocrinol Diabetes Metab Case Rep. 2019;2019.","DOI":"10.1530\/EDM-18-0124"},{"issue":"6","key":"1654_CR18","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1530\/eje.0.1480609","volume":"148","author":"S Diederich","year":"2003","unstructured":"Diederich S, Franzen NF, B\u00e4hr V, Oelkers W. Severe hyponatremia due to hypopituitarism with adrenal insufficiency: report on 28 cases. Eur J Endocrinol. 2003;148(6):609\u201317.","journal-title":"Eur J Endocrinol"},{"issue":"2","key":"1654_CR19","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1590\/S0004-27302011000200010","volume":"55","author":"BA Laway","year":"2011","unstructured":"Laway BA, Mir SA, Dar MI, Zargar AH. Sheehan\u2019s syndrome with central diabetes insipidus. Arq Bras Endocrinol Metabol. 2011;55(2):171\u20134.","journal-title":"Arq Bras Endocrinol Metabol"},{"issue":"12","key":"1654_CR20","doi-asserted-by":"publisher","first-page":"1533","DOI":"10.1210\/jcem-29-12-1533","volume":"29","author":"LG Goluboff","year":"1969","unstructured":"Goluboff LG, Ezrin C. Effect of pregnancy on the somatotroph and the prolactin cell of the human adenohypophysis. J Clin Endocrinol Metab. 1969;29(12):1533\u20138.","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"1654_CR21","first-page":"1939","volume":"16","author":"G Lavall\u00e9e","year":"1995","unstructured":"Lavall\u00e9e G, Morcos R, Palardy J, Aub\u00e9 M, Gilbert D. MR of nonhemorrhagic postpartum pituitary apoplexy. AJNR Am J Neuroradiol. 1995;16(9):1939\u201341.","journal-title":"AJNR Am J Neuroradiol"},{"issue":"6","key":"1654_CR22","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1111\/j.1365-2265.1989.tb00265.x","volume":"30","author":"IH Sherif","year":"1989","unstructured":"Sherif IH, Vanderley CM, Beshyah S, Bosairi S. Sella size and contents in Sheehan\u2019s syndrome. Clin Endocrinol (Oxf). 1989;30(6):613\u20138.","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"5346","key":"1654_CR23","doi-asserted-by":"publisher","first-page":"1679","DOI":"10.1136\/bmj.1.5346.1679-b","volume":"1","author":"JC Sloper","year":"1963","unstructured":"Sloper JC. Sheehan\u2019s syndrome and diabetes insipidus. BMJ. 1963;1(5346):1679.","journal-title":"BMJ"}],"container-title":["BMC Endocrine Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-024-01654-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12902-024-01654-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-024-01654-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T16:12:53Z","timestamp":1721751173000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcendocrdisord.biomedcentral.com\/articles\/10.1186\/s12902-024-01654-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,23]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["1654"],"URL":"https:\/\/doi.org\/10.1186\/s12902-024-01654-w","relation":{},"ISSN":["1472-6823"],"issn-type":[{"value":"1472-6823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,23]]},"assertion":[{"value":"6 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 July 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Institutional Review Board of National Cheng Kung University Hospital.approved this study (Approval No.: A-EC-112-017).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"120"}}