Conversion from Latent to Symptomatic Sheehan's Syndrome by Pegylated Interferon Therapy for Chronic Hepatitis C

A 58-year-old woman with chronic hepatitis C was admitted to our hospital to receive interferon (IFN) therapy. Twenty years earlier she had received blood transfusion because of obstetric hemorrhage. Blood test showed mild hypothyroidism and a relatively elevated eosinophil count. Therapy with pegyl...

Full description

Saved in:
Bibliographic Details
Published inInternal Medicine Vol. 47; no. 10; pp. 939 - 941
Main Authors Kanda, Keitaro, Kayahara, Takahisa, Seno, Hiroshi, Yamashita, Yukitaka, Chiba, Tsutomu
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 01.01.2008
Subjects
Adrenocorticotropic Hormone - therapeutic use
Antiviral Agents - adverse effects
endocrine abnormality
Female
Hepatitis C, Chronic - drug therapy
Hormones - therapeutic use
Humans
hypopituitarism
Hypopituitarism - etiology
Hypopituitarism - pathology
Interferon alpha-2
Interferon-alpha - adverse effects
Middle Aged
obstetric hemorrhage
Polyethylene Glycols - adverse effects
Postpartum Hemorrhage - physiopathology
Recombinant Proteins
Thyroxine - therapeutic use
Time Factors
Online AccessGet full text

Cover

More Information
Summary:A 58-year-old woman with chronic hepatitis C was admitted to our hospital to receive interferon (IFN) therapy. Twenty years earlier she had received blood transfusion because of obstetric hemorrhage. Blood test showed mild hypothyroidism and a relatively elevated eosinophil count. Therapy with pegylated IFNα-2a was started, and two days later she complained of nausea and severe malaise. Blood test showed hyponatremia, and plasma prolactin, growth hormone and cortisol levels were all decreased. A simultaneous administration test of lutenizing hormone releasing-, corticotrophin releasing-, growth hormone releasing- and thyrotropin releasing-hormones revealed that only adrenocorticotropic hormone was responsive. Magnetic resonance imaging showed atrophy of anterior lobe of pituitary gland. We diagnosed that IFN therapy disclosed latent Sheehan's syndrome due to previous obstetric hemorrhage. Following supplementation of thyroid and adrenal cortical hormones, we were able to complete IFN therapy. Thus, before IFN therapy for woman patients it is important to suspect latent Sheehan's syndrome when the patient had a history of obstetric hemorrhage.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.47.0990