International Journal of Academic Health and Medical Research (IJAHMR)   Year: 2023 | Volume: 7 | Issue: 4 | Page No.: 28-34 Acute Sheehan's Syndrome Presenting with Diabetes Insipidus: A Rare Case Report Download PDF M. Hamdi, H. Moustaide, I. Baouch, A. Zrigui, O. Fahim, Y. Motiaa, J. Nuiyekh, N. Louafi, W. Ftouh, M. Benkacem, S. Benkirane Abstract: Sheehan's syndrome, or postpartum pituitary necrosis, is a rare disorder with a complex and often delayed diagnosis. The initial damage is caused by massive postpartum hemorrhage (PPH) resulting in insufficient blood flow to the pituitary gland. Symptoms usually appear years after delivery but may become acute in rare cases. The most common and earliest hormone deficiency is GH deficiency, followed by other hormone deficiencies. Dysfunction of the posterior pituitary gland is more rare disorder responsible for the onset of diabetes insipidus secondary to antidiuretic hormone (ADH) deficiency. The authors report the case of a patient who presented clinically favorable to acute Sheehan syndrome 25 days after postpartum hemorrhage, with extreme weakness, incoercible vomiting, weight loss, amenorrhea, lack of lactation, polyuria, and polydipsia. Biological tests showed electrolyte disorders such as hyponatremia and hormonal deficits. Pituitary magnetic resonance imaging (MRI scan) showed an empty sella turcica aspect. The diagnosis of acute Sheehan syndrome with posterior pituitary and anterior pituitary insufficiency was retained. This case report describes the clinical, biological, and radiological characteristics of acute Sheehan syndrome and discusses the possibility of its early diagnosis and its first symptoms. Furthermore, it demonstrates the long-term efficacy of hormonal replacement as the only management option available and the importance of reducing postpartum hemorrhage as the best prevention method.