A 30-year-old woman presents 4 months postpartum with amenorrhea, fatigue, and galactorrhea cessation despite attempting breastfeeding. She experienced severe postpartum hemorrhage requiring transfusion. Vital signs: BP 92/58, HR 88, RR 16, Temp 36.8°C. Laboratory studies show TSH 2.1 mIU/L (normal). Serum prolactin is markedly decreased. She denies headaches or visual changes. Which hormone pattern best explains her clinical presentation and laboratory findings?
- A)High prolactin and low ACTH
- B)Normal prolactin and high growth hormone
- C)High prolactin and high TSH
- D)Low prolactin and low ACTHGABARITO
- E)Low prolactin and high ACTH
Explicação
Postpartum pituitary ischemia damages the anterior pituitary, causing low prolactin with failure of lactation and low ACTH with secondary adrenal insufficiency. This is the classic pattern of Sheehan syndrome. Amenorrhea can also result from low gonadotropins. Ver explicação completa e trilha adaptativa →