Abstract | OBJECTIVE: Antipituitary (APA) but not antihypothalamus antibodies (AHA) have been investigated in patients with idiopathic hypopituitarism. This study searched for APA and AHA in some of these patients to investigate whether pituitary or hypothalamic autoimmunity could play a role in their pituitary dysfunction. DESIGN: MEASUREMENTS: Antipituitary and AHA were evaluated by indirect immunofluorescence in sera of patients and controls. Positive sera were retested by a four-layer double immunofluorescence to identify the cells targeted by these antibodies. RESULTS: Antipituitary were present at high titre in 4 of 27 patients with ACTH deficiency (14·8%), 4 of 20 with GH deficiency (26%) and 5 of 19 with hypogonadotropic hypogonadism (21%) and targeted, respectively, corticotrophs, somatotrophs and gonadotrophs. AHA were found at high titre only in 5 patients with ACTH deficiency (18·5%), mostly targeting corticotrophin-releasing hormone-secreting cells; none of these 5 patients resulted positive for antipituitary antibodies. Among the controls, only 1 hypophysectomized patient resulted APA positive at low titre. CONCLUSIONS: Our results suggest that in patients with selective idiopathic hypopituitarism, detection of APA or AHA could better characterize an autoimmune process involving the pituitary or hypothalamus, respectively. In particular, detection of antibodies targeting selectively ACTH-secreting or corticotrophin-releasing hormone-secreting cells may differentiate, respectively secondary from tertiary variants of autoimmune hypoadrenalism.
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Authors | Annamaria De Bellis, Elena Pane, Giuseppe Bellastella, Antonio A Sinisi, Caterina Colella, Roberta Giordano, Claudia Giavoli, Andrea Lania, Maria R Ambrosio, Carolina Di Somma, Maria C Zatelli, Emanuela Arvat, Annamaria Colao, Antonio Bizzarro, Antonio Bellastella, Italian Autoimmune Hypophysitis Network Study |
Journal | Clinical endocrinology
(Clin Endocrinol (Oxf))
Vol. 75
Issue 3
Pg. 361-6
(Sep 2011)
ISSN: 1365-2265 [Electronic] England |
PMID | 21521324
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2011 Blackwell Publishing Ltd. |
Chemical References |
- Autoantibodies
- Human Growth Hormone
- Adrenocorticotropic Hormone
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Topics |
- Adrenocorticotropic Hormone
(deficiency)
- Adult
- Autoantibodies
(blood, immunology)
- Autoimmunity
(immunology)
- Female
- Fluorescent Antibody Technique, Indirect
(methods)
- Human Growth Hormone
(deficiency)
- Humans
- Hypophysectomy
(adverse effects)
- Hypopituitarism
(blood, etiology, immunology)
- Hypothalamus
(immunology, metabolism)
- Male
- Pituitary Gland
(immunology, metabolism)
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