A lack of ACTH is called Sheehan’s syndrome (HVL necrosis). It is triggered by medication or by a change in the anterior pituitary gland and is now easily treatable.
What is Sheehan Syndrome?
Sheehan’s syndrome is a functional failure of the anterior pituitary gland, which usually occurs after childbirth. The cause is a high blood loss and the resulting cell death. For kabuki syndrome in dictionary, please visit dictionaryforall.com.
Other shock conditions, such as burns, can also lead to HVL necrosis. The syndrome can be clearly diagnosed on the basis of various symptoms. Treatment is also possible thanks to modern medical techniques.
The anterior pituitary often recovers on its own. Normally, Sheehan’s syndrome cannot be prevented. However, hemophiliacs can take appropriate precautions to avoid excessive blood loss and the shock that accompanies it.
Causes
Sheehan syndrome is triggered by high blood loss with hypovolemic shock. This leads to reduced bleeding and a little later to ischemic necrosis of the anterior pituitary gland. The exact cause of the shock can be very different.
The syndrome usually occurs as a result of childbirth, since the blood loss is particularly high there. Injuries that result in high blood loss also lead to necrosis. This can be burns, severe cuts and similar things. However, an acute illness is usually the result of childbirth.
Bleeding directly from the anterior pituitary gland can also trigger Sheehan’s syndrome. It can be caused by a head injury and is often not even noticed by those affected. Those affected can only intervene when headaches and hormonal problems occur. Surgery is then an effective way to remove the bleeding and relieve symptoms.
Symptoms, Ailments & Signs
Sheehan’s syndrome occurs primarily after a complicated birth of a child with high blood loss in the mother. The following complaints are symptomatic: After the failure of the anterior lobe of the pituitary gland, there is no milk production (agalactorrhea) because prolactin is no longer released.
Other symptoms are a lack of menstruation (secondary amenorrhea) due to the loss of the hormones follicle-stimulating hormone (FSH) and luteinizing hormone (LH), hypothyroidism (hypothyroidism), abnormally increased urine output ( polyuria ) and abnormally increased thirst (polydipsia), a tendency to low blood sugar ( hypoglycemia ) due to the loss of growth hormone and the lack of adrenocorticotropin (a hormone that is also responsible for growth).
Loss of secondary body hair, lack of sexual desire (loss of libido), pallor of the skin (hypopigmentation) due to the lack of melanocyte-stimulating hormone and, in rare cases, during growth to short stature can also occur. In Sheehan’s syndrome, the anterior pituitary gland is partially or completely restricted in its function, which is why many of the necessary hormones cannot be produced.
Before the diagnosis, patients are often apathetic, indifferent and restricted in their living conditions. In rare cases, Sheehan’s syndrome can also lead to secondary adrenal insufficiency.
Diagnosis & History
Although Sheehan’s syndrome is a serious impairment, it can be difficult to diagnose. It often does not take place until years later, but it can also be asked after the birth. A clear sign is a loss of secondary body hair.
A lack of sexual desire and paleness of the skin can also be symptoms. Likewise, a lack of milk. This is usually the first symptom that is triggered by the loss of prolactin secretion. Due to the loss of the hormones FSH and LH, which are associated with the necrosis of the anterior pituitary gland, there is no menstruation. An underactive thyroid is also a common symptom. A tendency to hypoglycaemia can also be an indication.
The clearest sign, however, is discomfort in the area of the eyes. If visual disturbances occur after delivery, the suspicion of Sheehan’s syndrome is obvious. The reason for this is the course of the optic nerve, which is located in the immediate vicinity of the pituitary gland. Disorders of eye mobility are also known symptoms.
The exact diagnosis is made by a doctor. This examines the blood count, finds out about the previous medical history and excludes other diseases as the cause. The diagnosis can then be made relatively quickly.
The course of Sheehan’s syndrome can be very different. In some cases, the damaged body region will heal on its own. In other cases, the deficiency can lead to serious disorders and even coma. Early treatment is therefore essential.
Complications
The complications and symptoms of Sheehan’s syndrome depend very much on its severity, so that a general course cannot usually be predicted. However, those affected primarily suffer from a lack of milk leakage if the patient was pregnant. This can lead to growth disorders in the child, whereby the lack of milk leakage can be replaced by other products.
Menstruation is also negatively affected due to Sheehan’s syndrome, so that bleeding can stop completely. Those affected continue to suffer from a significant underfunction of the thyroid gland, which has a negative effect on their health. There is hair loss and sexual reluctance. The sexual disorders can have a very negative effect on the relationship with the partner and possibly lead to social problems.
In many cases, the patient’s skin is very pale. If Sheehan’s syndrome occurs in childhood, it often leads to short stature. As a rule, Sheehan’s syndrome can be treated relatively easily with the administration of hormones. There are no particular complications and in most cases the disease progresses positively. The life expectancy of those affected is usually not negatively affected by the syndrome.
When should you go to the doctor?
Treatment by a doctor is always necessary for Sheehan syndrome. Further complications can only be limited or completely prevented by early detection and treatment of the symptoms. The earlier Sheehan’s syndrome is detected, the better the further course of this disease. A doctor should be consulted if the person concerned suffers from a significant underfunction of the thyroid gland. This is usually noticeable through various complaints and symptoms and should always be treated by a doctor. Furthermore, permanent low blood sugar or very slow growth in children can indicate the disease and must also be examined by a doctor.
Insufficiency or other problems with the kidneys often indicate Sheehan’s syndrome and should be examined if they occur over a longer period of time and do not go away on their own. As a rule, self-healing cannot occur in Sheehan syndrome. Sheehan’s syndrome can be diagnosed by a general practitioner. However, further treatment depends on the exact symptoms and is then carried out by a specialist.
Treatment & Therapy
After the diagnosis has been made with the help of a blood test, Sheehan’s syndrome can be treated effectively. An important pillar of the therapy is the supply of the missing hormones. This is done by adding various preparations.
Furthermore, secondary diseases that have already occurred must be treated, which sometimes takes a lot of time. The hormonal changes can also cause psychological problems that make treatment difficult. It is then necessary to refer the patient to a psychiatrist. In most cases, however, it is sufficient to supply the missing hormones in order to restore the normal state.
Sheehan’s syndrome can also be treated surgically. In particular, if the pituitary gland is injured, neurosurgical intervention can bring improvement. The operation is performed through the nose and is very promising.
Prevention
Since Sheehan’s syndrome is usually caused by sudden blood loss, it is difficult to prevent. However, it is possible to closely monitor the delivery and particularly the function of the anterior pituitary to prevent necrosis in the first place. In the event of an accident, this is of course not possible.
However, if the first symptoms are recognized early, the syndrome can be diagnosed before the tissue has completely died. It is then often possible to restore function with therapy. Finally, if you fall on your head, you should see a doctor. Magnetic resonance imaging allows injuries to the pituitary gland to be detected early and then treated. This will at least prevent secondary diseases.
Aftercare
In the case of Sheehan’s syndrome, the patient usually only has very limited and very few direct follow-up measures available. The person affected should therefore ideally consult a doctor at the first symptoms and signs of the disease in order to prevent the occurrence of other complaints and complications. The sooner a doctor is consulted, the better the further progression of the disease.
Since Sheehan’s syndrome is a genetic disease, it cannot usually be completely cured. Therefore, if the person concerned wishes to have children, they should undergo genetic testing and counseling to prevent the syndrome from reoccurring in their children.
In most cases, those affected by Sheehan syndrome are dependent on taking various medications, which can reduce the symptoms. It is always important to ensure that it is taken regularly and that the dosage is correct in order to alleviate the symptoms. If anything is unclear or you have any questions, consult a doctor first. The disease itself does not limit the life expectancy of the patient.
You can do that yourself
Special preparations are used to treat Sheehan syndrome, which replace the missing hormones. In the context of self-help, it is also important to consider the subsequent secondary diseases. These are often psychological complaints that are closely linked to the therapy itself and put a great strain on the patient.
Targeted therapy with a psychiatrist helps those affected to cope with their situation. It can drag on for a long time and boosts the patient ‘s self-esteem. At the same time, those affected should observe their own body so that they can recognize any changes at an early stage. In this way, serious accidents or falls can be avoided.
Such situations can be avoided by regularly taking the prescribed hormones. This drug therapy can be easily integrated into everyday duties. This ensures the usual bodily functions and those affected can lead a normal life. Good contact with the doctor is also helpful, because patients should make an appointment at short notice if they are experiencing difficulties that are already known or if they are experiencing new problems. In this way, worse consequences can be avoided at an early stage.
