Autoimmunity in Sheehan's Syndrome
The presence of anti-pituitary antibodies (APAs) has been demonstrated in some patients with SS, suggesting that an autoimmune pituitary process could be involved in this syndrome.[48,49] Hypothalamic cell anti-hypothalamus antibodies (AHAs), but not against arginine vasopressin AVP-secreting cells, have also been described. The significance of these antibodies is, however, unclear, but they may destroy the remaining pituitary cells with time. It is proposed that sequestered antigens due to tissue necrosis could trigger autoimmunity and may cause delayed hypopituitarism in these patients.[49] However, other studies did not detect APAs in this syndrome.