Variations in Endocrine Gland Function in Postpartum Pituitary Necrosis*

Postpartum pituitary necrosis in 4 patients was manifest by classic panhypopituitarism with secondary insufficiency of the thyroid, adrenal cortex, and ovary. Three other patients presented atypical syndromes characterized by virtually normal thyroid function, variable degrees of adrenocortical insufficiency, and normal to slightly elevated urinary excretion of gonadotropin, with or without the resumption of menses. Low 24-hour thyroidal I131 uptakes were associated with low urinary gonadotropin levels, and normal uptakes with higher gonadotropin levels. It is inferred that in some cases of postpartum pituitary necrosis there may be decreased ACTH secretion, nearly normal TSH secretion, and restored gonadotropin secretion which, however, may not be adequate for normal ovarian function.