Fig. 1Prevalence of hormone deficiencies in patients with Sheehan's syndrome. GH, growth hormone; PRL, prolactin; FSH, follicle-stimulating hormone; LH, luteinizing hormone; TSH, thyroid-stimulating hormone; ACTH, adrenocorticotrophic hormone.
Fig. 2Prevalence of electrolyte imbalances in patients with Sheehan's syndrome.
Table 1Clinical Features of Patients with Sheehan's Syndrome
Variable |
Sheehan's syndrome (n=78) |
Age at diagnosis, yr |
54.0 (42.8-63.3) |
Body mass index, kg/m2
|
22.0 (20.0-24.0) |
Mental status on initial visit, normal/confusion/coma |
61 (78.2)/14 (17.9)/3 (3.8) |
Loss of lactation |
73 (93.6) |
Age at menopause, yr |
33 (29.0-40.0) |
Hypoglycemia (glucose<55 mg/dL) on initial visit |
3 (3.8) |
Diabetes mellitus |
8 (10.3) |
Hypertension |
8 (10.3) |
Infection |
10 (12.8) |
Diabetes insipidus |
0 |
MRI scan of sella: empty sella, total/partial |
47 (60.3)/31 (39.7) |
Table 2Characteristics of Patients with Sheehan's Syndrome and Control Subjects
Characteristic |
Sheehan's syndrome (n=78) |
Controls (n=95) |
P value |
Age at diagnosis, yr |
54.0 (42.8-63.3) |
49.5 (43.3-54.8) |
0.105 |
Body mass index, kg/m2
|
22.0 (20.0-24.0) |
25.1 (22.6-27.0) |
<0.001 |
Hemoglobin, g/dL |
11.0 (10.0-12.0) |
12.8 (11.9-13.5) |
<0.001 |
Sodium, mEq/L |
131.0 (117.5-139.0) |
140.0 (139.0-142.0) |
<0.001 |
Potassium, mEq/L |
3.8 (3.4-4.1) |
4.0 (3.7-4.3) |
0.002 |
Total calcium, mg/dL |
8.8 (8.6-9.2) |
9.1 (8.8-9.3) |
0.204 |
Ionized calcium, mEq/L |
2.2 (2.1-2.3) |
2.4 (2.3-2.5) |
<0.001 |
Magnesium, mg/dL |
1.9 (1.7-2.0) |
2.2 (2.1-2.4) |
0.002 |
Inorganic phosphorus, mg/dL |
3.1 (2.6-3.6) |
3.7 (3.2-4.0) |
0.004 |
Creatinine, mg/dL |
0.8 (0.6-1.0) |
0.6 (0.5-0.7) |
<0.001 |
HbA1c, % |
5.8 (5.5-6.6) |
5.8 (5.4-8.3) |
0.967 |
Total cholesterol, mg/dL |
220.0 (180.5-260.5) |
196.0 (162.0-234.8) |
0.140 |
Triglyceride, mg/dL |
137.0 (101.0-191.5) |
132.5 (70.0-182.3) |
0.449 |
HDL-C, mg/dL |
52.0 (36.5-63.0) |
51.0 (40.0-63.0) |
0.703 |
LDL-C, mg/dL |
145.0 (111.0-177.0) |
134.0 (98.0-164.5) |
<0.001 |
Serum osmolality, mOsm/kg |
268.0 (243.0-291.8) |
302.5 (283.3-309.8) |
<0.001 |
Urine osmolality, mOsm/kg |
386.0 (300.0-586.0) |
306.5 (161.3-485.0) |
0.216 |
Table 3Correlation between Hormone Levels and Electrolytes in the Study Subjects
Variable |
Na |
K |
Ca (i) |
P |
Mg |
TSH |
|
|
|
|
|
Basal |
-0.091 |
-0.021 |
0.296a
|
0.034 |
-0.020 |
Peak |
0.263b
|
0.046 |
0.290b
|
0.220a
|
0.229 |
Delta |
0.344c
|
0.094 |
0.323b
|
0.259a
|
0.185 |
FT4 |
0.425c
|
0.106 |
0.264a
|
0.123 |
0.161 |
ACTH |
|
|
|
|
|
Basal |
-0.002 |
-0.042 |
0.175 |
0.010 |
0.046 |
Peak |
0.305c
|
0.182a
|
0.352b
|
0.058 |
0.139 |
Delta |
0.310c
|
0.262b
|
0.428c
|
0.116 |
0.384b
|
Cortisol |
|
|
|
|
|
Basal |
0.332c
|
0.209b
|
0.226a
|
0.073 |
0.198 |
Peak |
0.455c
|
0.248b
|
0.304b
|
0.156 |
0.254 |
Delta |
0.425c
|
0.263b
|
0.282b
|
0.109 |
0.276a
|
GH |
|
|
|
|
|
Basal |
0.287c
|
0.147 |
0.255a
|
0.185 |
0.201 |
Peak |
0.461c
|
0.182a
|
0.315b
|
0.278a
|
0.213 |
Delta |
0.442c
|
0.174a
|
0.344b
|
0.258a
|
0.228 |
PRL |
|
|
|
|
|
Basal |
0.312c
|
0.01 |
0.270a
|
0.212a
|
0.169 |
Peak |
0.463c
|
0.11 |
0.415c
|
0.270a
|
0.282 |
Delta |
0.458c
|
0.14 |
0.455c
|
0.252a
|
0.277 |
LH |
|
|
|
|
|
Basal |
0.211b
|
0.069 |
0.317b
|
-0.035 |
0.110 |
Peak |
0.330c
|
0.069 |
0.257a
|
0.061 |
0.177 |
Delta |
0.341c
|
0.070 |
0.226a
|
0.155 |
0.062 |
FSH |
|
|
|
|
|
Basal |
0.202a
|
0.042 |
0.230a
|
0.019 |
0.250 |
Peak |
0.354c
|
0.078 |
0.297b
|
0.076 |
0.262 |
Delta |
0.323c
|
0.039 |
0.246a
|
0.196 |
0.173 |