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Longitudinal behavior of autoimmune GH deficiency: from childhood to transition age.

Abstract：

BACKGROUND:Some cases of apparently idiopathic GH deficiency (GHD) may be caused by pituitary autoimmunity. OBJECTIVE:To study the variations in pituitary function and antipituitary antibodies (APA) from childhood to transition age in patients with apparently idiopathic GHD. DESIGN:We conducted a longitudinal study. PATIENTS AND METHODS:Pituitary function and APA detection by immunofluorescence were investigated in 24 childhood patients with isolated GHD before starting recombinant GH therapy and after the stopping of this therapy in transition age. Sera of patients positive for APA were processed by double immunofluorescence to identify their pituitary target. RESULTS:At diagnosis, 16 out of 24 patients were APA positive targeting only somatotrophs (group 1), while the remaining eight were APA negative (group 2). When retested off therapy, 12 out of 16 patients in group 1 persisted being APA positive, while the remaining four became negative with recovery of pituitary function. All patients in group 2 persisted being APA negative but still showing GHD. Of the 12 patients persistently APA positive, eight with confirmed GHD showed APA still targeting somatotrophs, whereas four showed APA targeting only gonadotrophs associated with isolated hypogonadotropic hypogonadism (HH). CONCLUSION:Patients with APA at middle but not at high titer in childhood may show a remission of autoimmune GHD in childhood after GH replacement therapy. As APA may shift their target in transition period, an early characterization of APA by double immunofluorescence is advisable in APA positive GHD patients showing delayed puberty, to allow an early diagnosis and an appropriate therapy, thus preventing the progression toward HH.

journal_name

Eur J Endocrinol

journal_title

European journal of endocrinology

authors

De Bellis A,Bellastella G,Maiorino MI,Aitella E,Lucci E,Cozzolino D,Bellastella A,Bizzarro A,Giugliano D,Esposito K,Italian Autoimmune Hypophysitis Network Group.

doi

10.1530/EJE-15-0766

subject

Has Abstract

pub_date

2016-03-01 00:00:00

pages

381-7

issue

3

eissn

0804-4643

issn

1479-683X

pii

EJE-15-0766

journal_volume

174

pub_type

杂志文章

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