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A Journal on Obstetrics and Gynecology

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Minerva Ginecologica 2016 Jul 13

language: English

A primer on pituitary injury for the obstetrician gynecologist: Simmonds disease, Sheehan’s syndrome, Traumatic injury, Dahan’ s syndrome, Pituitary Apoplexy and Lymphocytic Hypophysitis

Michael H. DAHAN, SeangLin TAN

McGill Reproductive Center, McGill University, Royal Victoria Hospital, Montreal, QC, Canada


The pituitary gland plays a critical role in reproduction. In response to the hypothalamus the anterior pituitary secretes prolactin, thyroid stimulating hormone (TSH), Adreno corticotropic hormone (ACTH), follicle stimulating hormone (FSH), luteinizing hormone (LH) and growth hormone. Dysregulation in these hormones often lead to reproductive failure. Multiple mechanisms of pituitary injury exist. Simmond’s disease is atrophy or destruction of the anterior lobe of the pituitary gland resulting in hypopitiutaryism. Sheehan’s syndrome is post-partum pituitary injury due to massive hemorrhage. Tramautic injury resulting in hemorrhage in a non-pregnancy state can also cause partial or complete pituitary failure. Dahan`s syndrome is pituitary injury due to severe vasospasm, without significant haemorrhage. Pituitary apoplexy is infarction of a pituitary adenoma and intra-mass haemorrhage with result injury to hormone production by the gland. Lymphocytic infiltration is the most common cause of hypophysitis and the mechanism is often unknown, although it may be auto immune related. The mechanism and treatments of each of these pathologies will be discussed in a context of reproduction.

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