摘要
Sheehan's症候群在臨床上是屬少見的病例。一位27歲女性病人主訴兩年前生產時發生大出血，之後健康狀況一路走下坡。目前主要是頭暈、偏頭痛、失眠、口齒不清、已經停經。兩年來到處尋醫都沒有確定的診斷。由上面簡單的病史讓我們直覺地感到她很可能是得了Sheehan's症候群。因此從這方面去檢查。結果發現她所有腦下垂體前葉的激素都有缺乏的情況。經prednisone、thyroxine、premarin/provera的治療後病情有戲劇性的改變。病人主訴她似乎已經改運了。另外，此病人的去氫皮質酮(dehydroepiandrosterone, DHEA)與生長激素(growth hormone, GH)亦明顯不足；但因經濟問題，未能做進一步處置。抗利尿激素(antidiuretic hormone, ADH)方面此病人並沒有不正常，在給prednisone前後，我們都很小心地注意病人的小便量，它都維持在每天2公升上下。
並列摘要
Clinically, Sheehan's syndrome is a rare occurrence now. A 27-years-old women complained of continuing down-hill of her health status after a severe postpartum hemorrhage about 2 years ago. Now she suffered chiefly from dizziness、migraine、insomnia、slurred speech、and menopause. From the above simple history, we feeled that this could be a case of Sheehan's syndrome. So we started to research this case from the viewpoint of hypopituitarism. Finally we found that she had deficiencies of all the hormones from the anterior pituitary gland. After treatment with prednisolone、thyroxine、and premarin/provera, her health status is dramatically improved. This patient also has apparent DHEA and growth hormone deficiencies, but they are left untreated due to economic problem. Her ADH status is normal. Before and after prednisolone treatment, we carefully evaluate her daily urine amount. It is maintained between 1500-2000 ml/d.
延伸閱讀
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