Unveiling a syndrome through recurrent hypoglycemia

Post-partum hypopituitarism, widely known as Sheehan syndrome, is an ischemic necrosis of the pituitary gland. This event is the result of profound hypotension that is usually caused by massive bleeding or less often in disseminated intravascular coagulation in the peripartum or more frequently during the postpartum period. The sequelae of this catastrophic event are generally subtle, with varying degrees of anterior pituitary hormonal deficiency. Despite this syndrome decreasing worldwide, some cases are occasionally diagnosed in underdeveloped countries because of the improvements and advances in obstetric overall care, and the long-standing experience and recognition of the syndrome, especially in developed countries. The syndrome often progresses slowly; therefore, clinicians face great challenges in making early diagnoses. The most distinctive feature is usually the history of postpartum bleeding, with failure of lactation, cessation of menstruation, and ill-health with vague symptoms that jeopardize the quality of the patient’s life. We had handled a young lady with previously mentioned symptoms but with striking bouts of recurrent hypoglycemia, especially during long fasting. The early noticeable constellation of symptoms and signs with classical history can facilitate early diagnosis, alleviate morbidity and mortality, and improve the overall quality of the patient's life. Most patients will lead a normal life after they have a timely diagnosis and receive the optimal hormonal substitutions.