PITUITARY COMA REVEALING SHEEHANS SYNDROME: A CASE REPORT

Introduction:Postpartum hypopituitarism has been known as Sheehan syndrome since 1937. It is often an insidious revelation but can also be an acute one with coma and collapse, which was the case of our patient reported below.

Clinical case: Patient aged 37, admitted to the intensive care unit in a state of anasarca and coma. In view of her clinical features associated with hyponatremia, acute adrenal insufficiency was suspected. requiring degressive boluses of hydrocortisone hemisuccinate. The diagnosis was supported by biological evidence. Subsequent medical records revealed a haemorrhagic haemorrhagic childbirth dating back 6 years with absence of lactation and progressively incapacitating physical and psychological asthenia. Sheehans syndrome was suspected in this clinical situation and confirmed on MRI. The patient was put on daily oral replacement of the deficient axes.

Discussion: Myxedema coma is exceptional in Sheehans syndrome. Severe forms require an initial stay in intensive care, followed by multidisciplinary consultation in order to manage the multiple complications and to introduce hormone replacement therapy.