# Delayed Diagnosis of Sheehan’s Syndrome Following Postpartum Hemorrhage and Emergency Hysterectomy: A Case Report

## TL;DR

A woman was diagnosed with Sheehan’s syndrome five years after childbirth due to severe postpartum hemorrhage, after her symptoms were initially misattributed to other conditions.

## Contribution

This case emphasizes the need for early recognition of Sheehan’s syndrome in women with a history of severe postpartum hemorrhage and chronic symptoms.

## Key findings

- The patient's symptoms were misdiagnosed for five years before Sheehan’s syndrome was identified.
- Endocrine testing confirmed central hypothyroidism, adrenal insufficiency, and low IGF-1.
- Hormone replacement therapy led to significant clinical improvement.

## Abstract

This case report describes a 50-year-old woman diagnosed with Sheehan’s syndrome, a rare form of hypopituitarism resulting from severe postpartum hemorrhage during a cesarean section in 2019, which led to cardiac arrest and emergency hysterectomy. Despite experiencing persistent fatigue, muscle pain, constipation, and mood changes for five years, her symptoms were repeatedly misattributed to anxiety, anemia, and vitamin D deficiency. A detailed review of her obstetric history, combined with endocrine testing showing central hypothyroidism, adrenal insufficiency, and low IGF-1, led to the correct diagnosis. Initiation of glucocorticoid and thyroid hormone replacement resulted in significant clinical improvement. This case highlights the importance of considering Sheehan’s syndrome in women with nonspecific chronic symptoms and a history of severe obstetric hemorrhage to enable timely diagnosis and treatment.