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Sheehan氏病 3例 報告

Sheehan´s Syndrome (Postpartum Necrosis of Adenohypophysis ) A Clinical Study of three Cases

최신의학 1962년 5권 3호 p.127 ~ 133
蔡應錫, 金東旭, 李祥鍾,
소속 상세정보
蔡應錫 (  ) - 延世大學校 醫科大學 內科
金東旭 (  ) - 延世大學校 醫科大學 內科
李祥鍾 (  ) - 延世大學校 醫科大學 內科

Abstract


The term Sheehan´s syndrome refers to those instances of hypopituitarism due to adenchypophysial necrosis resulting from post-partum hemorrhage. It should be emphasized that Simmonds´ disease, hypophysial cachexia and Sheehan´s syndrome all refer to hypopituitarism and are therefore synonymous although the former two terms are generally identified with the most severe instances of this disease.
We have seen three patients with Sheehan´s syndrome at our hospital during the past two years, and both clinical and laboratory finding in them showing pituitary insufficiency are presented.
All patients had a typical history of severe postpartum hemorrhage associated with transient shock occurring just prior to the onset of various signs and symptoms, such as amenorrhea, asthenia insidious weight loss, diminution or loss of axillary and pubic hair, atrophy of genitalia and breasts, decreased libido, intolerance to cold, with hypothermia especially in both palm and soles, nervous irritability, and so on. Laboratory data disclosed the following reduced basal metabolic rate, tendency to lowered fasting blood sugar, extremely low level of urinary neutral 17- ketosteroid excretion, and lowered excretion of urinary gonadotropin.
All responded beneficially with combined administration of thyroid extract, prednisolone or Dexamethasone, and androgen.
The major stumbling block in the clinical recognition of this disease lies practically in its confusion with anorexia nervosa, and sometimes with primary myxedema or psychoneurosis.
General considerations of Sheehan´s syndrome were briefly discussed.

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