A 35 years old mother of two children is suffering from amenorrhea for last 12 months. She has history of failure of lactation following 2nd delivery but remained asymptomatic thereafter. Skull radiography shows "Empty sella". Most likely diagnosis is:
Lack of lactation in the postpaum period and early menopause is the 'punch line' for the diagnosis of Sheehan syndrome. It only occurs in post paum females who experienced PPH with hypovolemic shock causing pituitary apoplexy and hypopituitarism Symptoms of Sheehan's syndrome Failure of postpaum Lactation Failure to menstruate following delivery Secondary hypothyroidism Adrenal failure Hypogonadism Prolactin Growth hormone deficiency. Hyponatremia visual field loss Headache Radiological features: CT shows ring enhancement surrounding low attenuation empty sella Sheehan syndrome is mostly ruled out if a woman is breast feeding post delivery.
Menopause
Pituitary tumor
Sheehan's syndrome
Intraductal papilloma of breast
Normal Menstruation, Abnormal Menstruation, Menopausal Physiology and forsight of conception