CLINICAL AND LABORATORY EVALUATION OF 40 PATIENTS WITH SHEEHANS-SYNDROME

Forty patients with typical obstetric history of Sheehan's syndrome we re reviewed retrospectively. Together with baseline laboratory values, insulin hypoglycemia test was evaluated in 15 patients, thyrotropin-r eleasing hormone (TRH) in 27 and luteinizing hormone-releasing hormone (LH-RH) in 7 patients. Baseline hormone values suggested secondary hy pothyroidism, hypogonadotropic hypogonadism and hypocortisolemia. Acco rding to the results of the anterior pituitary stimulation tests, one patient (6.6%) showed normal cortisol response and one patient (6.6%) showed normal growth hormone response to hypoglycemia. Nine patients ( 33.3%) who were clinically and biochemically hypothyroid demonstrated adequate TSH response to TRH. None of the patients showed normal prola ctin response to TRH. Four out of seven amenorrheic patients (57.1%) h ad adequate follicle-stimulating hormone and/or LH responses to LH-RH. It has been concluded that isolated anterior pituitary hormone defici encies may occur in patients with Sheehan's syndrome. Prolactin respon se to TRH seems the most sensitive screening test for detecting Sheeha n's syndrome in patients with typical obstetric history.