Sheehan’s syndrome complicated with Graves’ disease in a woman with a 20-year history of hypothyroidism

Sheehan’s syndrome is a disorder caused by ischemic necrosis of the pituitary gland following postpartum hemorrhage, typically resulting in pituitary dysfunction that can affect the adrenal, thyroid, and gonadal axes. Clinically, patients may present with dysfunction of a single axis or multiple axe...

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Main Authors: ManLi Yan, Jingyun Zhang, Yiting Wang, Hua Wei
Format: Article
Language:English
Published: SAGE Publishing 2025-08-01
Series:Journal of International Medical Research
Online Access:https://doi.org/10.1177/03000605251363777
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author ManLi Yan
Jingyun Zhang
Yiting Wang
Hua Wei
author_facet ManLi Yan
Jingyun Zhang
Yiting Wang
Hua Wei
author_sort ManLi Yan
collection DOAJ
description Sheehan’s syndrome is a disorder caused by ischemic necrosis of the pituitary gland following postpartum hemorrhage, typically resulting in pituitary dysfunction that can affect the adrenal, thyroid, and gonadal axes. Clinically, patients may present with dysfunction of a single axis or multiple axes. The co-occurrence of Sheehan’s syndrome and Graves’ disease is extremely rare, posing a significant diagnostic challenge. Herein, we report the case of a woman in her early 50s with a 28-year history of Sheehan’s syndrome, which had led to complete pituitary dysfunction, who had been managing hypothyroidism for the past 20 years. However, over a 6-month period, she developed chronic diarrhea and showed progressive weight loss and laboratory results indicating hyperthyroidism. Based on further imaging and laboratory findings, along with her medical history, a diagnosis of Sheehan’s syndrome complicated with Graves’ disease was established, as evidenced by elevated levels of thyrotropin receptor antibodies. Treatment included adrenocorticotropic hormone replacement, antithyroid therapy, and other supportive measures. Although her gastrointestinal symptoms and weight loss resolved initially, the patient continued to experience persistent hyperthyroidism and elevated thyrotropin receptor antibody levels at the 20-month follow-up. This case highlights the need for regular endocrine monitoring in patients with Sheehan’s syndrome, particularly those with long-standing hypothyroidism, to promptly identify and address the potential overlap of autoimmune thyroid diseases.
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spelling doaj-art-35d82306605f4f80a30dfd795bdcfaf52025-08-20T03:59:22ZengSAGE PublishingJournal of International Medical Research1473-23002025-08-015310.1177/03000605251363777Sheehan’s syndrome complicated with Graves’ disease in a woman with a 20-year history of hypothyroidismManLi YanJingyun ZhangYiting WangHua WeiSheehan’s syndrome is a disorder caused by ischemic necrosis of the pituitary gland following postpartum hemorrhage, typically resulting in pituitary dysfunction that can affect the adrenal, thyroid, and gonadal axes. Clinically, patients may present with dysfunction of a single axis or multiple axes. The co-occurrence of Sheehan’s syndrome and Graves’ disease is extremely rare, posing a significant diagnostic challenge. Herein, we report the case of a woman in her early 50s with a 28-year history of Sheehan’s syndrome, which had led to complete pituitary dysfunction, who had been managing hypothyroidism for the past 20 years. However, over a 6-month period, she developed chronic diarrhea and showed progressive weight loss and laboratory results indicating hyperthyroidism. Based on further imaging and laboratory findings, along with her medical history, a diagnosis of Sheehan’s syndrome complicated with Graves’ disease was established, as evidenced by elevated levels of thyrotropin receptor antibodies. Treatment included adrenocorticotropic hormone replacement, antithyroid therapy, and other supportive measures. Although her gastrointestinal symptoms and weight loss resolved initially, the patient continued to experience persistent hyperthyroidism and elevated thyrotropin receptor antibody levels at the 20-month follow-up. This case highlights the need for regular endocrine monitoring in patients with Sheehan’s syndrome, particularly those with long-standing hypothyroidism, to promptly identify and address the potential overlap of autoimmune thyroid diseases.https://doi.org/10.1177/03000605251363777
spellingShingle ManLi Yan
Jingyun Zhang
Yiting Wang
Hua Wei
Sheehan’s syndrome complicated with Graves’ disease in a woman with a 20-year history of hypothyroidism
Journal of International Medical Research
title Sheehan’s syndrome complicated with Graves’ disease in a woman with a 20-year history of hypothyroidism
title_full Sheehan’s syndrome complicated with Graves’ disease in a woman with a 20-year history of hypothyroidism
title_fullStr Sheehan’s syndrome complicated with Graves’ disease in a woman with a 20-year history of hypothyroidism
title_full_unstemmed Sheehan’s syndrome complicated with Graves’ disease in a woman with a 20-year history of hypothyroidism
title_short Sheehan’s syndrome complicated with Graves’ disease in a woman with a 20-year history of hypothyroidism
title_sort sheehan s syndrome complicated with graves disease in a woman with a 20 year history of hypothyroidism
url https://doi.org/10.1177/03000605251363777
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AT jingyunzhang sheehanssyndromecomplicatedwithgravesdiseaseinawomanwitha20yearhistoryofhypothyroidism
AT yitingwang sheehanssyndromecomplicatedwithgravesdiseaseinawomanwitha20yearhistoryofhypothyroidism
AT huawei sheehanssyndromecomplicatedwithgravesdiseaseinawomanwitha20yearhistoryofhypothyroidism