Organ- and non-organ-specific auto-antibodies in children with hypopituitarism on growth hormone therapy
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Serum non-organ-specific antibodies (NOSA) against nuclear, mitochondrial (AMA), smooth muscle, liver/kidney microsomal (LKM), reticulin, ribosomal, and organ-specific antibodies (OSA) against pituitary gland, gonads (testis, ovary) adrenal cortex, thyroid (thyroglobulin and microsomal), pancreas islet cells, gastric parietal cells and intestinal epithelial cells were evaluated in 45 patients with hypopituitarism (mean age 12.4±4.0 years). In 22 of them, 9 with isolated growth hormone (GH) deficiency (IGHD) and 13 with multiple pituitary hormone deficiency, MRI showed anterior pituitary hypoplasia with structural stalk abnormality and ectopic posterior pituitary. Twelve had isolated small anterior pituitary and IGHD and 11 had normal morphology of pituitary gland and IGHD. Controls were healthy age-sex-matched subjects. Thyroid antibodies were detected by a passive haemagglutination test while indirect immunofluorescence was used for the others. The auto-antibodies were found in 7/45 asymptomatic patients, a frequency not significantly different from that in controls; 5 were type NOSA and 2 type OSA. Pituitary antibodies were positive in 1 girl with IGHD and normal pituitary morphology. One girl developed hyperthyroidism during the follow up. Autoantibodies were equally distributed between the three groups and the frequency was not dissimilar from that in controls; this suggests that these patients are not at a higher risk of developing auto-immune disease, at least during the first two decades.
Pituitary insufficiency in children with different MRI features seems unlikely to be secondary to an auto-immune process.
Key wordsHypopituitarism Auto-immunity MRI Auto-antibodies Panhypopituitarism
isolated GH deficiency
liver/kidney microsomal antibodies
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- 4.Bottazzo GF, McIntoch C, Stanford W, Preece M (1980) Growth hormone cell antibodies and partial growth hormone deficiency in a girl with Turner's syndrome. Clin Endocrinol (Oxf) 12: 1–9Google Scholar
- 8.Di Chiro G, Nelson KB (1962) Volume of the sella turcica. Am J Radiol 87: 989–1008Google Scholar
- 14.Kiess W, Malozowski A, Gelato M, Butenandt O, Doerr H, Crisp B, Eisl E, Maluish A, Belohradsky BH (1988) Lymphocyte subset distribution and natural killer activity in growth hormone deficiency before and during short-term treatment with growth hormone releasing hormone. Clin Immunol Immunopathol 48: 85–94CrossRefPubMedGoogle Scholar
- 22.Mau M, Philips TM, Ratner RE (1993) Presence of anti-pituitary hormone antibodies in patients with empty sella syndrome and pituitary tumours. Clin Endocrinol (Oxf) 38: 495–500Google Scholar
- 24.Nienhuis HE, Rongen-Westerlaken CR, Geertzen HGM, Rijkers GT, Zegers BJM, Wit JM (1993) Longterm effect of human growth hormone therapy on the prevalence of autoantibodies in Turner syndrome. Horm Res 39 [Suppl 2]: 49–53Google Scholar
- 26.Robbins JB, Skinner RG, Pearson HA (1979) Autoimmune hemolytic anemia in a child with congenital X-linked hypogammaglobulinemia. N Engl J Med 280: 70–79Google Scholar