A 32 year old woman presents 2 weeks after delivery because she has been unable to breastfeed and feels profoundly fatigued. She had severe postpartum hemorrhage requiring transfusion. Blood pressure is 92 over 58 mm Hg. Laboratory studies show low cortisol, low TSH, and low prolactin. Which of the following is the most likely diagnosis?
- A)Pituitary prolactinoma
- B)Primary adrenal insufficiency
- C)Sheehan syndromeGABARITO
- D)Postpartum thyroiditis
- E)Lymphocytic hypophysitis
Explicação
Sheehan syndrome is ischemic necrosis of the enlarged anterior pituitary after severe postpartum hemorrhage. The inability to lactate from low prolactin, hypotension, and multiple low anterior pituitary hormones strongly support this diagnosis. The posterior p... Ver explicação completa e trilha adaptativa →