Sheehan Syndrome Presenting with Psychotic Manifestations Mimicking Schizophrenia in a Young Female: A Case Report and Review of the Literature

Table 2

Summary of case reports describing patients presenting with psychotic manifestations due to Sheehan syndrome.

Author, year	Age at presentation	Interval between psychiatric manifestations and childbirth	Psychiatric manifestations	Hormone deficiencies	Notes
Lightenberg and Cader, 1959 [10]	37 years	12 days	Auditory and olfactory hallucinations, delusions.; Apathy, disorientation. No details on other cognitive functions.	TSH, ACTH, gonadotropin, and prolactin	Twice improves without replacing deficient hormones, but relapsed. MRI-pituitary not reported.
Hanna, 1970 [11]	55 years	19 years	Delusions and auditory hallucinations; Impaired cognition including disorientation and poor memory.	Gonadotropin, TSH, ACTH. Symptoms of hypopituitarism have lasted long before psychiatric manifestations; No details about prolactin levels or lactation	One week after presentation developed seizures, coma, and hypotension. MRI pituitary not reported.
Kitis and Johnson, 1976 [12]	48 years	10 years	Auditory hallucinations, paranoid delusions, and aggressive behavior.; Depression.; No details on cognition, attention, and concentration.	Gonadotropins, prolactin, TSH, ACTH (hormone deficiency persisted at least 4 years before the onset of psychiatric manifestations)	Six years after childbirth, Sheehan syndrome diagnosed, but the patient defaulted.; MRI pituitary not reported.
Leo et al., 1998 [13]	57 years	29 years	Paranoid delusions and auditory hallucinations.; Apathy and dysphoria.; Normal memory and attention	Gonadotropins, prolactin, TSH, ACTH (onset of any of the hormone deficiencies not clear from history)	Initially diagnosed as schizoaffective disorder with poor response.
Kale et al., 1999 [14]	21 years	15–20 days	Hallucinations, persecutory delusions, and delusions of infidelity.Orientation normal. No cognitive assessment.	Gonadotropins, prolactin, TSH, ACTH	No history of postpartum haemorrhage.
Shoib, 2013 [15]	31 years	16–18 days	Persecutory delusions, auditory hallucinations. Intact memory, poor attention, concentration, and verbal fluency.	Gonadotropins, prolactin, TSH, ACTH
Reddy, 2017 [16]	42 years	11 years	Delusions of persecutions and second person auditory hallucinations. Has forgetfulness, no details on cognition, attention, and concentration.	Gonadotropins, prolactin (onset soon after childbirth) TSH, ACTH (onset not defined)
Nath et al., 2018 [17]	43 years	13 years	Catatonia, reduced speaking, and reduced emotional reactivity. No details about cognition, attention, and concentration.	Gonadotropins, prolactin (onset soon after childbirth) TSH, ACTH (onset not defined)
Shiekh et al., 2018 [18]	37 years	2 years	Persecutory delusions, auditory hallucinations. Normal memory. Poor attention and concentration.	Gonadotropins, prolactin (onset soon after childbirth) TSH, ACTH (onset not defined)

^∗No diabetes insipidus in any of the patients. Growth hormone was not tested in any of the patients.