A 21-year-old woman experiences abruptio placentae with severe bleeding during the delivery of a term fetus. Five months later, she presents with profound lethargy, pallor, muscle weakness, failure of lactation, and amenorrhea. Which of the following pathologic findings is expected in this patient?
This patient experienced postpartum ischemic necrosis of the pituitary (Sheehan syndrome). This commonly, but not exclusively, occurs after severe hypotension induced by postpartum hemorrhage. The pituitary is particularly susceptible at this time because its enlargement during pregnancy renders it vulnerable to a reduction in blood flow. Major clinical manifestations of panhypopituitarism include pallor (decreased MSH), hypothyroidism (decreased TSH), failure of lactation (decreased prolactin), adrenal insufficiency, and ovarian failure (decreased FSH and LH). None of the other choices lead to this constellation of hormone deficiencies.Diagnosis: Sheehan syndrome
Atrophy of the endocrine pancreas
Autoimmune destruction of the adrenal cortex
Infarction of the pituitary
Pituitary prolactinoma
Endocrine