Abstract
45 hypopituitary patients (29 M, 16 P) aged 3-22 years were studied for autoimmunity. Serum non-organ-specific antibodies (NOSA-Ab) such as nuclear, DNA, mitochondrial (MA), smooth muscle (SMA), liver/kidney microsomal (LKM), reticulum (RA), ribosomal and organ-specific antibodies (OSA) against pituitary gland, testis, adrenal cortex, ovary, thyroid (thyroglobulin and microsomal), pancreas islet cells, gastric parietal cells (PCA) and intestinal epithelial cells were evaluated. Thyroid antibodies were detected by passive haemagglutination test while indirect immunofluorescence was used for the others. 98 healthy age-sex-matched subjects were used as controls. Magnetic resonance imaging revealed: anterior pituitary hypoplasia, stalk agenesis and ectopic posterior pituitary lobe in 22 patients, 9 with isolated GH deficiency (IGHD) and 13 with multiple pituitary hormone deficiencies; isolated anterior pituitary hypoplasia in 12 IGHD;apparently normal pituitary gland in 11 lGHD.
The frequency of autoantibodies was not significantly different in controls as they were present in 7 patients (15.5%): MA in 1 case, SMA in 2, MA and LKM in 1 and RA in 1; PCA in 1 case and pituitaiy-Ab in 1 case with normal pituitary gland. Only one female without thyroid-ab developed Graves hyperthyroidism at puberty.
Pituitary insufficiency in our patients seems unlikely to be secondary to an autoimmune process as observed in adults; this suggests that pituitary hypoplasia has a different etiology. Patients with hypopituitarism have not a higher risk of developing autoimmune disease than normal subjects at least during the first two decades; this indicates the presence of normal immune surveilance. The autoimmune involvement of hypothalamus remains to be determined.
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Severi, F., Lorini, R., Preti, P. et al. AUTOIMMUNITY IN HYPOPITUITARISM. Pediatr Res 33 (Suppl 5), S34 (1993). https://doi.org/10.1203/00006450-199305001-00186
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DOI: https://doi.org/10.1203/00006450-199305001-00186