POMC and Sezary syndrome: At least 75% of the pituitary must be infarcted before clinical manifestations become evident.5 The clinical manifestations of Sheehan syndrome involve some form of anterior lobe hormonal dysfunction.19 Growth hormone and prolactin level decreases are evident in 90% to 100% of cases, thyroid-stimulating hormone and adrenocorticotropic hormone decreases in 55% to 100% of cases, and follicle-stimulating hormone and luteinizing hormone deficiencies in 9% to 100% of cases.5,16