UNRECOGNIZED PITUITARY NECROSIS (SHEEHAN'S SYNDROME)

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Abstract
The clear relationship between a destructive lesion of the anterior portion of the hypophysis and the striking deficiency syndrome associated with it was first described by Simmonds, who attributed the ischemic necrosis to an infarct resulting from minute bacterial emboli lodging in the sinuses of the gland.1It was subsequently suggested by Reye that thrombosis of the small sinuses of the anterior lobe of the pituitary could result in necrosis, and that sudden hypotension would favor its occurrence.2He also pointed out that the enlarged pituitary of pregnancy and the hypotension resulting from severe post-partum hemorrhage would be an especially predisposing combination of circumstances for such thrombosis.3The latter suggestion was factually supported by the observations of several pathologists who noted the association of pituitary necrosis and postpartum hemorrhage.4However, the clinical importance of the relationship of post-partum hemorrhage to pituitary necrosis was not clearly understood

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