Abstract | CONTEXT: OBJECTIVE: Our objective was to search for AHA and characterize their hypothalamic target in patients with autoimmune hypopituitarism to clarify, on the basis of the cells stained by these antibodies, the occurrence of autoimmune subclinical/clinical central diabetes insipidus (CDI) and/or possible joint hypothalamic contribution to their hypopituitarism. DESIGN: We conducted a cross-sectional cohort study. PATIENTS: MAIN OUTCOME MEASURES: AHA by immunofluorescence and posterior pituitary function were evaluated; then AHA-positive sera were retested by double immunofluorescence to identify the hypothalamic cells targeted by AHA. RESULTS: AHA were detected at high titer in 12 patients in group 1 and in eight patients in group 2. They immunostained arginine vasopressin (AVP)-secreting cells in nine of 12 in group 1 and in four of eight in group 2. All AVP cell antibody-positive patients presented with subclinical/clinical CDI; in contrast, four patients with GH/ ACTH deficiency but with APA staining only GH-secreting cells showed AHA targeting CRH- secreting cells. CONCLUSION: The occurrence of CDI in patients with lymphocytic hypophysitis seems due to an autoimmune hypothalamic involvement rather than an expansion of the pituitary inflammatory process. To search for AVP antibody in these patients may help to identify those of them prone to develop an autoimmune CDI. The detection of AHA targeting CRH-secreting cells in some patients with GH/ ACTH deficiency but with APA targeting only GH-secreting cells indicates that an autoimmune aggression to hypothalamus is jointly responsible for their hypopituitarism.
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Authors | A De Bellis, A A Sinisi, E Pane, A Dello Iacovo, G Bellastella, G Di Scala, A Falorni, C Giavoli, V Gasco, R Giordano, M R Ambrosio, A Colao, A Bizzarro, A Bellastella, Italian Autoimmune Hypophysitis Network Group |
Journal | The Journal of clinical endocrinology and metabolism
(J Clin Endocrinol Metab)
Vol. 97
Issue 10
Pg. 3684-90
(Oct 2012)
ISSN: 1945-7197 [Electronic] United States |
PMID | 22855340
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Autoantibodies
- Human Growth Hormone
- Adrenocorticotropic Hormone
- Corticotropin-Releasing Hormone
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Topics |
- Adrenocorticotropic Hormone
(metabolism)
- Adult
- Antibody Specificity
(immunology)
- Autoantibodies
(immunology)
- Autoimmune Diseases
(epidemiology, immunology)
- Cohort Studies
- Corticotropin-Releasing Hormone
(metabolism)
- Cross-Sectional Studies
- Diabetes Insipidus, Neurogenic
(epidemiology, immunology)
- Female
- Human Growth Hormone
(metabolism)
- Humans
- Hypopituitarism
(epidemiology, immunology, surgery)
- Hypothalamus
(immunology)
- Male
- Seroepidemiologic Studies
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