{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:12:11Z","timestamp":1790619131726,"version":"4.1.0"},"reference-count":10,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:00:00Z","timestamp":1752192000000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Acute Sheehan syndrome is a rare condition that occurs hours to days post partum and causes hypopituitarism. It may cause hyponatremia due to adrenal insufficiency, and most patients improve with steroid therapy. However, hyponatremia is caused not only by adrenal insufficiency but also by inappropriate secretion of arginine vasopressin (AVP). We report the case of a 30-year-old Japanese primipara with massive postpartum hemorrhage and acute Sheehan syndrome. Hyponatremia developed following hypernatremia soon after the postpartum period; however, it did not improve despite adequate hydrocortisone supplementation. AVP fluctuated based on water balance and magnetic resonance imaging findings, showing distinctive AVP secretion dynamics. Oral 1-desamino-8-D-arginine vasopressin was temporarily needed during the clinical course, after which it was not needed, suggesting that impaired blood flow to the posterior pituitary lobe and its improvement may have contributed to the distinctive AVP secretion dynamics. Therefore, when hyponatremia is not improved despite adequate hydrocortisone supplementation in patients with acute Sheehan syndrome, the syndrome of inappropriate antidiuretic hormone secretion should be considered because distinctive AVP secretion dynamics can occur after severe ischemia of the pituitary gland.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf134","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T06:57:31Z","timestamp":1752217051000},"source":"Crossref","is-referenced-by-count":1,"title":["Acute Sheehan Syndrome With Distinctive Arginine Vasopressin Secretion and Magnetic Resonance Imaging Findings"],"prefix":"10.1210","volume":"3","author":[{"given":"Yuki","family":"Minamoto","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Osaka City General Hospital , Osaka 534-0021 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumiko","family":"Sasai","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Osaka City General Hospital , Osaka 534-0021 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yui","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Osaka City General Hospital , Osaka 534-0021 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9099-7673","authenticated-orcid":false,"given":"Keiko","family":"Yamagami","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Osaka City General Hospital , Osaka 534-0021 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Fujisawa","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kishiwada City Hospital , Osaka 596-8501 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4541-0981","authenticated-orcid":false,"given":"Naotetsu","family":"Kanamoto","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Osaka City General Hospital , Osaka 534-0021 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2025,7,11]]},"reference":[{"issue":"1","key":"2025071102572861100_luaf134-B1","doi-asserted-by":"crossref","first-page":"16092","DOI":"10.1038\/nrdp.2016.92","article-title":"Sheehan syndrome","volume":"2","author":"Karaca","year":"2016","journal-title":"Nat Rev Dis Primers"},{"issue":"2","key":"2025071102572861100_luaf134-B2","doi-asserted-by":"crossref","first-page":"99","DOI":"10.3109\/09513590009167667","article-title":"Demonstration of reserved anterior pituitary function among patients with amenorrhea after postpartum 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infusion","volume":"67","author":"Takagi","year":"2020","journal-title":"Endocr J"},{"key":"2025071102572861100_luaf134-B6","first-page":"7592648","article-title":"Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and subsequent central diabetes insipidus: a rare presentation of pituitary apoplexy","volume":"2019","author":"Smedegaard","year":"2019","journal-title":"Case Rep Endocrinol"},{"issue":"1","key":"2025071102572861100_luaf134-B7","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1210\/clinem\/dgac622","article-title":"Disorders of salt and water balance after pituitary surgery","volume":"108","author":"Brooks","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2025071102572861100_luaf134-B8","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1507\/endocrj.EJ13-0280","article-title":"A novel hook-shaped enhancement on contrast-enhanced sagittal magnetic resonance image in acute Sheehan's syndrome: a case 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