Report of 18 patients with Sheehan's syndrome [a case series]

Sheehan's syndrome has a broad spectrum of clinical and laboratory signs that range from nonspecific symptoms such as malaise, fatigue and anemia to severe hypophyseal insufficiency, which results in coma and death. We collected data from 18 patients diagnosed with Sheehan's syndrome during the past 10 years. Patients profiles, including history, physical examination, clinical presentation that lead to diagnosis, routine biochemical tests, lipid profiles, thyroid function tests, and basal hypophyseal hormone levels were reviewed. The time spent for making a definitive diagnosis of the disease ranged between 10 to 30 years with a mean of 15.55 +/- 5.04 years. Five patients [22%] had disturbances in their levels of consciousness at the time of presentation [four with hypoglycemia, one with severe hypothyroidism] Seven patients [39%] were evaluated for central hypothyroidism in outpatient service before definite diagnosis. All of the patients had a history of massive hemorrhage at delivery and lack of postpartum milk production. All of the patients have received replacement doses of Levothyroxine and Prednisolone. Considering the duration of disease, significant delays appear to occur in its diagnosis and treatment

[Eosinophilic gastroenteritis with clinical manifestations of small bowel obstruction: a case report]

Eosinophilic gastroenteritis is a rare disease with eosinophilic infiltration of the wall of the gastrointestinal tract, especially in stomach and small bowel. The etiology of the disease is unknown. A 61 year man was admitted because of epigastric pain for 10 days with burning quality with an increase after each meal. Laboratory tests showed mild leukocytosis with 5% eosinophilia, mildly elevated ESR and CRP and serum IgE at upper normal limit. Increased mucosal thickness was shown in posterior gastric wall and the descending part of duodenum seemed narrow with thick irregular wall. CT scan and esophago-gastro-duedenoscopy revealed gastric distention and erythema in D1 region with luminal narrowing. Pathology report from D1, showed inflammatory infiltration with eosinophilia in lamina propria. The patient was treated with oral prednisolone. All complaints and manifestations disappeared soon after treatment and the radiologic studies showed normal image