A 28-year-old woman develops failure of lactation and amenorrhea 6 months after a delivery complicated by severe postpartum hemorrhage and hypotension. Which is the most likely diagnosis?
- A Prolactinoma
- B Sheehan syndrome (postpartum pituitary necrosis) ✓
- C Craniopharyngioma
- D Lymphocytic hypophysitis
Correct answer: B. Sheehan syndrome (postpartum pituitary necrosis)
Explanation
Sheehan syndrome is ischemic necrosis of the anterior pituitary occurring after postpartum hemorrhage with hypotension. The enlarged pregnant pituitary is vulnerable to hypoperfusion. It presents with failure of lactation, amenorrhea, and panhypopituitarism. Prolactinoma causes hyperprolactinemia. Craniopharyngioma is a congenital tumor. Lymphocytic hypophysitis is autoimmune, often peripartum, but not related to hemorrhage.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.