{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T22:34:38Z","timestamp":1769985278405,"version":"3.49.0"},"reference-count":5,"publisher":"The Endocrine Society","issue":"10","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We report a 28-year-old woman with refractory hypoglycemia, hypotension, and profound fatigue found to have panhypopituitarism secondary to Sheehan syndrome. Although she had a remote history of postpartum hemorrhage marked by agalactia and secondary amenorrhea, her diagnosis was delayed until she developed an adrenal crisis in the setting of acute pyelonephritis. Comprehensive endocrine testing confirmed secondary adrenal insufficiency, central hypothyroidism, hypogonadotropic hypogonadism, and lactotroph failure; Magnetic resonance imaging demonstrated a partially empty sella consistent with remote pituitary infarction. Prompt initiation of stress-dose glucocorticoids and thyroid hormone led to rapid hemodynamic stabilization and resolution of hypoglycemia. This case underscores the importance of early recognition of subtle hypopituitarism signs\u2014particularly postpartum lactation failure\u2014and the need to consider endocrine etiologies in critical care presentations that mimic septic shock.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf190","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T11:21:03Z","timestamp":1756466463000},"source":"Crossref","is-referenced-by-count":1,"title":["Lifting the Veil: Delayed Diagnosis of Sheehan Syndrome Unmasked by Adrenal Crisis"],"prefix":"10.1210","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0007-4719","authenticated-orcid":false,"given":"Amanda","family":"Alkhafaji","sequence":"first","affiliation":[{"name":"Henry Ford Providence Southfield Internal Medicine , Southfield, MI 48075 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5595-1600","authenticated-orcid":false,"given":"Dhruva","family":"Govil","sequence":"additional","affiliation":[{"name":"Henry Ford Providence Southfield Internal Medicine , Southfield, MI 48075 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Shaya","sequence":"additional","affiliation":[{"name":"Henry Ford Providence Southfield Internal Medicine , Southfield, MI 48075 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Ather","sequence":"additional","affiliation":[{"name":"Henry Ford Providence Southfield Internal Medicine , Southfield, MI 48075 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"issue":"3","key":"2025082908265719000_luaf190-B1","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1507\/endocrj.50.297","article-title":"Sheehan's syndrome: clinical and laboratory evaluation of 20 cases","volume":"50","author":"Kilinc","year":"2003","journal-title":"Endocr J"},{"issue":"11","key":"2025082908265719000_luaf190-B2","doi-asserted-by":"crossref","first-page":"3888","DOI":"10.1210\/jc.2016-2118","article-title":"Hormonal replacement in hypopituitarism in adults: an endocrine society clinical practice guideline","volume":"101","author":"Fleseriu","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"issue":"9571","key":"2025082908265719000_luaf190-B3","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1016\/S0140-6736(07)60673-4","article-title":"Hypopituitarism","volume":"369","author":"Schneider","year":"2007","journal-title":"Lancet"},{"issue":"4","key":"2025082908265719000_luaf190-B4","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1507\/endocrj.45.451","article-title":"Sheehan's syndrome of more than 30 years\u2019 duration: an endocrine and MRI study of 6 cases","volume":"45","author":"Otsuka","year":"1998","journal-title":"Endocr J"},{"issue":"1","key":"2025082908265719000_luaf190-B5","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"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/3\/10\/luaf190\/64160536\/luaf190.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/3\/10\/luaf190\/64160536\/luaf190.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T12:27:05Z","timestamp":1756470425000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luaf190\/8243882"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,19]]},"references-count":5,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,8,19]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luaf190","relation":{},"ISSN":["2755-1520"],"issn-type":[{"value":"2755-1520","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,10]]},"published":{"date-parts":[[2025,8,19]]},"article-number":"luaf190"}}