European Journal of Pediatrics

, Volume 154, Issue 6, pp 450–453 | Cite as

Organ- and non-organ-specific auto-antibodies in children with hypopituitarism on growth hormone therapy

  • M. Maghnie
  • R. Lorini
  • L. Vitali
  • N. Mastricci
  • A. M. Carrà
  • F. Severi
Endocrinology Original Paper
  • 30 Downloads

Abstract

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.

Conclusion

Pituitary insufficiency in children with different MRI features seems unlikely to be secondary to an auto-immune process.

Key words

Hypopituitarism Auto-immunity MRI Auto-antibodies Panhypopituitarism 

Abbreviations

AMA

mitochondrial antibodies

GH

growth hormone

IGHD

isolated GH deficiency

LKM

liver/kidney microsomal antibodies

NOSA

non-organ-specific antibodies

OSA

organ-specific antibodies

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References

  1. 1.
    Abbassi V, Bellanti JA (1985) Humoral and cell-mediated immunity in growth hormone-deficient children: effect of therapy with human growth hormone. Pediatr Res 19: 299–301PubMedGoogle Scholar
  2. 2.
    Baroni C, Fabris N, Bertoli G (1969) Effects of hormones on development and function of lymphoid tissues. Synergistic action of thyroxin on somatotropic hormone in pituitary dwarf mice. Immunology 17: 303–314PubMedGoogle Scholar
  3. 3.
    Bottazzo GF, Pouplard A, Florin-Christensen A, Doniach D (1975) Autoantibodies to prolactin-secreting cells of human pituitary. Lancet I: 97–101CrossRefGoogle Scholar
  4. 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
  5. 5.
    Bozzola M, Cisternino M, Valtorta A, Moretta A, Biscaldi I, Maghnie M, De Amici M, Schimpff RM (1989) Effect of biosynthetic methionyl growth hormone (GH) therapy on the immune function in GH-deficient children. Horm Res 31: 153–156PubMedGoogle Scholar
  6. 6.
    Bright GM, Blizzard RM, Kaiser DL, Clarke WL (1982) Organ-specific autoantibodies in children with common endocrine diseases. J Pediatr 100: 8–14PubMedGoogle Scholar
  7. 7.
    Conley ME, Park CL, Douglas SD (1986) Childhood common variable immunodeficiency with autoimmmune disease. J Pediatr 108: 915–922PubMedGoogle Scholar
  8. 8.
    Di Chiro G, Nelson KB (1962) Volume of the sella turcica. Am J Radiol 87: 989–1008Google Scholar
  9. 9.
    Etzioni A, Pollack S, Hochberg Z (1988) Immune function in growth hormone-deficient children treated with biosynthetic growth hormone. Acta Paediatr Scand 77: 169–170PubMedGoogle Scholar
  10. 10.
    Fabris N, Pierpaoli W, Sorkin E (1971) Hormones and the immunological capacity IV. Restorative effects of developmental hormones or of lymphocytes on the immunodeficiency syndrome of the dwarf mouse. Clin Exp Immunol 9: 227–241PubMedGoogle Scholar
  11. 11.
    Fleisher TA, White RM, Broder S, Nissley P, Blaese RM, Mulvihill JJ, Olive G, Waldmann TA (1980) X-linked hypogammaglobulinemia and isolated growth hormone deficiency. N Engl J Med 302: 1429–1434PubMedGoogle Scholar
  12. 12.
    Gluck M, Attanasio A, Speer U, Butenandt O, Tietze HU, Scherbaum WA (1992) Prevalence of autoantibodies to endocrine organs in girls with Ullrich-Turner syndrome aged 5–14 years. Horm Res 38: 114–119PubMedGoogle Scholar
  13. 13.
    Gupta S, Fikrig SM, Novel MS (1983) Immunological studies in patients with isolated growth hormone deficiency. Clin Exp Immunol 54: 87–90PubMedGoogle Scholar
  14. 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
  15. 15.
    Komatsu M, Kondo T, Yamauchi K, Yokokawa N, Ichikawa K, Ishihara M, Aizawa T, Yamada T, Imai Y, Tanaka K, Taniguchi K, Watanabe T, Takahashi Y (1988) Antipituitary antibodies in patients with the primary empty sella syndrome. J Clin Endocrinol Metab 67: 633–638PubMedGoogle Scholar
  16. 16.
    Larizza D, Martinetti Bianchi M, Lorini R, Maghnie M, Dugoujon JM, Cuccia Belvedere, Severi F (1989) Autoimmunity, HLA, Gm and Km polymorphisms in Turner's syndrome. Autoimmunity 4: 69–78PubMedGoogle Scholar
  17. 17.
    Llera AS, Cardoso AI, Del Rosario Stampo R, Martinez AS, Heinrich JJ, Poskus E (1993) Detection of autoantibodies against hGH in sera of idiopathic hypopituitary children. Clin Immunol Immunopathol 66: 114–119CrossRefPubMedGoogle Scholar
  18. 18.
    Lorini R, Larizza D, Livieri C, Cammareri V, Martini A, Plebani A, Zanaboni D, Severi F (1986) Auto-immunity in children with diabetes mellitus and in their relatives. Eur J Pediatr 145: 182–184CrossRefPubMedGoogle Scholar
  19. 19.
    Lorini R, Orecchia G, Martinetti M, Dugoujon JM, Cuccia M (1992) Autoimmunity in vitiligo: relationship with HLA, Gm and Km polymorphisms. Autoimmunity 11: 255–260PubMedGoogle Scholar
  20. 20.
    Maghnie M, Triulzi F, Larizza D, Preti P, Priora C, Scotti G, Severi F (1991) Hypothalamic-pituitary dysfunction in growth hormone-deficient patients with pituitary abnormalities. J Clin Endocrinol Metab 73: 79–83PubMedGoogle Scholar
  21. 21.
    Maghnie M, Monafo V, Marseglia GL, Valtorta A, Avanzini A, Moretta A, Balottin U, Touraine JL, Severi F (1992) Immunodeficiency, growth hormone deficiency and central nervous system involvement in a girl. Thymus 20: 69–76PubMedGoogle Scholar
  22. 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
  23. 23.
    Monafo V, Maghnie M, Terraciano L, Valtorta A, Massa M, Severi F (1991) X-linked agammaglobulinemia and isolated growth hormone deficiency: another case. Acta Paediatr Scand 80: 563–566PubMedGoogle Scholar
  24. 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
  25. 25.
    Rapaport R, Oleske J, Ahdieh H, Solomon S, Delfaus C, Denny T (1986) Suppression of immune function in growth hormone-deficient children during treatment with human growth hormone. J Pediatr 109: 434–439PubMedGoogle Scholar
  26. 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
  27. 27.
    Sitz KV, Burks W, Williams LW, Kemp SF, Steele RW (1990) Confirmation of X-linked hypogammaglobulinemia with isolated growth hormone deficiency as a disease entity. J Pediatr 116: 292–294PubMedGoogle Scholar
  28. 28.
    Spadoni GL, Rossi P, Ragno W, Galli E, Cianfarani S, Galasso C, Boscherini B (1991) Immune function in growth hormone-deficient children treated with biosynthetic growth hormone. Acta Paediatr Scand 80: 75–79PubMedGoogle Scholar
  29. 29.
    Tang MLK, Kemp AS (1993) Growth hormone deficiency and combined immunodeficiency. Arch Dis Child 68: 231–232.PubMedGoogle Scholar
  30. 30.
    Wilson NW, Daaboul J, Bastian JF (1990) Association of autoimmunity with IgG2 and IgG4 subclass deficiency in a growth hormone-deficient child. J Clin Immunol 10: 330–334PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • M. Maghnie
    • 1
  • R. Lorini
    • 1
  • L. Vitali
    • 1
  • N. Mastricci
    • 1
  • A. M. Carrà
    • 1
  • F. Severi
    • 1
  1. 1.Department of PaediatricsUniversity of PaviaPaviaItaly

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