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Antipituitary antibodies in adults with apparently idiopathic HGH human growth hormone deficiency and in adults with autoimmune endocrine diseases.

De Bellis A - J Clin Endocrinol Metab - 01-FEB-2003; 88(2): 650-4
NLM Citation ID:
12574195 (PubMed)
Full Source Title:
Journal of Clinical Endocrinology and Metabolism
Publication Type:
Journal Article
Author Affiliation:
Department of Clinical and Experimental Medicine and Surgery F. Magrassi, A. Lanzara, Second University of Naples, 80131 Naples, Italy.
De Bellis A; Bizzarro A; Conte M; Perrino S; Coronella C; Solimeno S; Sinisi AM; Stile LA; Pisano G; Bellastella A
The role of antipituitary antibodies (APA) in autoimmune pituitary diseases still needs to be clarified. The aim of this study was 2-fold: first, to investigate the presence of APA in adults with idiopathic or acquired HGH deficiency (HGH-D) and in adults with autoimmune endocrine diseases; and second, to evaluate whether in autoimmune endocrine patients APA titer is correlated to the pituitary function and particularly to GH secretion. We studied 12 adults with isolated and apparently idiopathic HGH-D who were treated with recombinant HGH in childhood (group 1a), 14 patients with adult HGH-D secondary to surgery for pituitary and parasellar tumors (group 1b), and 180 patients with organ-specific autoimmune diseases (group 2). APA were evaluated by indirect immunofluorescence. In all APA-positive patients and in 20 APA-negative patients of group 2, GH secretion was investigated by testing its response to insulin-induced hypoglycemia (insulin tolerance test) and, when impaired, also to arginine. APA were found (at high titers) in 4 of 12 patients of group 1a (33.3%) but were absent in all patients in group 1b. APA were also found in 40 of 180 patients of group 2 (22.2%), 35 of them at low titers (group 2a) and 5 at high titers (group 2b). Twenty of the 140 autoimmune endocrine APA-negative patients studied (group 2c) and all APA-positive patients at low titers (group 2a) had normal pituitary function. Conversely, all APA-positive patients at high titers (groups 1a and 2b) had a severe isolated H-GHD. An inverse correlation between APA titers and HGH peak serum response to insulin tolerance test in autoimmune endocrine patients was observed. Our results suggest that APA, when detected at high titers, may be considered a good diagnostic tool to highlight the possible occurrence of HGH-D in adults with autoimmune endocrine diseases. Moreover, they may indicate an autoimmune pituitary involvement in adults with apparently idiopathic HGH-D, suggesting that the prevalence of autoimmune HGH-D is much higher than that so far considered.
Major Subjects:

Additional Subjects:

Chemical Compound Name:
(Autoantibodies); 12629-01-5(Human Growth Hormone)

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