[Current aspect of Sheehan's syndrome. 20 cases]. / Aspect actuel du syndrome de Sheehan. Vingt observations.

The 20 women investigated were 22 to 59 years old (average 35.9 +/- 2.3 years) when the diagnosis of Sheehan's syndrome was confirmed. Fourteen had had previous pregnancies, 6 were primiparas; average parity was 4. The patients were delivered in hospital, in France, in 14 cases, and abroad (Algeria, Portugal) at home in 6 cases. A history of severe haemorrhage during delivery was recorded in all but 2 cases. This was serious enough to warrant hysterectomy in 2 cases. Agalactia and amenorrhea were observed in all but 1 case in the immediate post-partum period. Transient polyuria and polydipsia occurred in 3 patients. In the months following birth, most women lead restricted lives; they were apathetic, asthenic and indifferent. The diagnosis was established under three different circumstances: in the majority (15/20) on clinical grounds, in 3 cases after acute adrenal failure, in 2 cases, fortuitously. Clinical examination showed signs of global anterior hypophyseal insufficiency involving thyroid, adrenal and gonad stimulating hormones in 14 cases; in 6 cases, the pituitary failure was dissociated. Corticotrophin, somatotropin and prolactin deficiencies were observed in all patients; gonadotrophin (17/20) and thyrotrophin (16/20) deficiencies were common. The diagnosis was confirmed less than 1 month (2 cases) to over 12 years (7 cases) after obstetric haemorrhage (average 6.9 +/- 1.9 years). No correlation was observed between the severity of the syndrome and this time interval. The short term outcome was favourable with return of menstruation and even pregnancy in one patient.(ABSTRACT TRUNCATED AT 250 WORDS)

[Parathyroid adenoma disclosed by a cold nodule on thyroid scintigraphy. 2 cases]. / Adénome parathyroïdien révélé par un nodule hypofixant à la scintigraphie thyroïdienne. Deux observations.

Two unusual cases of parathyroid adenoma were diagnosed in different circumstances. In the first case, pathological examination of a thyroid lobectomy specimen disclosed a large parathyroid adenoma. In the second case, the association of clinical and biological manifestations of hyperparathyroidism with a "cold" nodule of the right lobe suggested the diagnosis which was confirmed by surgery and pathological examination. In addition to the classical causes of "cold" thyroid nodules, a large parathyroid adenoma should be considered. Routine investigations for clinical and biological manifestations of such an adenoma are advocated.

[Hyperandrogenism due to adrenal enzyme deficiency: possibility of pregnancy. Five cases (author's transl)]. / Hyperandrogénie par déficit enzymatique surrénalien: possibilité de grossesse. Cinq observations.

Five women suffering from hyperandrogenism due to adrenal enzyme deficiency, with various clinical symptoms and discovered at a more or less early stage, had a total of 7 pregnancies. 21-hydroxylase was deficient in three, and 11-beta-hydroxylase in two women. The pregnancies occured 6 months to 10 years after corticosteroid treatment was started in four cases, and after it was discontinued in a case of partial deficiency in 11-beta-hydroxylase. Four women delivered on term, two of them normally and two by caesarean section. The fifth woman delivered prematurely on the 33rd week. Two pregnancies were interrupted either spontaneously or voluntarily. None of the newborn babies (three girls and two boys) showed any abnormality. With the exception of the premature girl, their weight was normal. The oldest of the girls had a normal puberty at the age of thirteen.