A case of hypopituitarism with pancytopenia cured by corticosteroid and thyroid hormone replacement therapy.

Abstract

Summary: Pancytopenia associated with hypopituitarism has been reported in the literature as a rare occurrence limited to isolated case reports, predominantly associated with Sheehan syndrome. We present the case of a 31-year-old woman who showed hematological features of pancytopenia and normal cellularity of bone marrow. Hematological investigation disclosed no other cause for pancytopenia. Her physical findings (generalized weakness, slow speech and no pubic or axillary hair) and history of a previous massive postpartum hemorrhage suggested Sheehan's syndrome, and the pituitary hormonal studies revealed panhypopituitarism. Her blood cell accounts were completely recovered after 5 months of glucocorticoid and thyroxine replacement therapy. We hereby report our experience of a cure of pancytopenia and the normal marrow originating from hypopituitarism after corticosteroid and thyroid hormone replacement therapy.

Learning points: Sheehan's syndrome correlates with postpartum hemorrhage and causes pancytopenia. It could be successfully treated with glucocorticoid. It could be successfully treated with thyroxine replacement therapy.