A Patient with Postpartum Hypopituitarism (Sheehan's Syndrome) Developed Postpartum Autoimmune Thyroiditis (Transient Thyrotoxicosis and Hypothyroidism): A Case Report and Review of the Literature
Table 3
Endocrine studies at 6 months post partum.
(a) Urinary cortisol (studied one week after discontinuation of hydrocortisone)
(Normal references)
Urinary cortisol nmol/day
<18 (30–230)
(b) CRH, TRH, and GnRH tests (CRH, TRH, and GnRH tests were done separately)
0 min
30 min
60 min
90 min
120 min
Response
CRH test (studied one week after discontinuation of hydrocortisone)
ACTH pmol/L
<0.4
<0.4
<0.4
<0.4
<0.4
No
Cortisol nmol/L
<5.5
<5.5
<5.5
<5.5
<5.5
No
TRH test
TSH mIU/L
17.4
38.1
52.9
57.1
57.7
Delayed
Prolactin pmol/L
43.5
178.3
160.9
165.2
139.1
Low
GnRH test
LH IU/L
0.5
6.6
11.1
13.1
13.7
Delayed
FSH IU/L
2.2
2.6
3.3
3.9
4.3
Delayed
Normal references for basal ACTH, cortisol, TSH, prolactin, LH, and FSH appear in Table 2.
(c) Insulin tolerance test (ITT) for GH releases
−30 min
0 min
30 min
60 min
90 min
120 min
GH μg/L
1.0
1.1
0.8
4.1
3.8
2.5
BG nmol/L
4.6
4.3
2.2
3.1
3.7
4.3
BG: blood glucose. Normal references for basal GH appear in Table 2.
(d) ADH (antidiuretic hormone), plasma osmolality, and urine osmolality at 9:00
