Abstract

Sheehans Syndrome (SS) is postpartum hypopituitarism caused by ischemic necrosis of the pituitary gland. Usually it results from severe hypotension or shock caused by massive haemorrhage during or after delivery. Enlargement of pituitary gland, small sellar size, DIC and autoimmunity are considered as other causal factors. Its incidence is currently decreasing in developed countries owing to improved obstretic care. We are here by presenting a case report of 53 year old female who had history of PPH during her second pregnancy, presented to casuality with complaints of fever, vomiting, loose stools and shortness of breath. On evaluation she was diagnosed as SCRUB typhus and found to have pancytopenia which did not improve with the treatment of underlying infection. In due course patient developed hyponatremia. On subsequent evaluation she was diagnosed to have hypocortisolism and hypothyroidism. MRI Pituitary was suggestive of SHEEHANS SYNDROME. In view of non specific presentation and little importance paid to the menstrual history there was a delay in the diagnosis and treatment.