Pituitary autoantibodies have been detected in patients with endocrine autoimmune diseases as well as in various pituitary diseases but their role in determining pituitary dysfunction is not clear. The aim of the present study was to evaluate anterior and posterior pituitary function in a group of patients with detectable pituitary autoantibodies.
31 patients (29 women and 2 men) were enrolled in the study: 21 patients affected by Hashimotos thyroiditis (HT), 3 patients with Graves disease (GD), 6 patients with non toxic multinodular goiter (NTMG) and one with Addisons disease (AD). No patient had previous history of cranial trauma. Pituitary autoantibodies were determined through an immunofluorescence assay. Anterior pituitary function was assessed by dynamic testing, including GHRH+arginine, CRH, TRH, GnRH when appropriate. Posterior pituitary function was assessed by prolonged water deprivation test. MRI of sella turcica was performed in patients when pituitary dysfunction was present.
Severe GH deficiency (peak GH<9 ng/ml) was observed in 7 patients (22,6%; 1 AD, 4 HT, 2 NTMG) and moderate GH deficiency (9<peak GH<16 ng/ml) in 6 patients (19,4%; 3 HT, 1 GD, 2 NTMG). AD patient was found to have partial diabetes insipidus. All patients tested with TRH, CRH and GnRH had normal hormonal response. Four patients performed pituitary MRI: 2 had normal pituitary imaging and 2 had partial empty sella.
In conclusion, these results suggest that pituitary autoantibodies could be involved in pituitary dysfunction, in particular we observed a high prevalence of GH deficiency.
01 - 05 Apr 2006
European Society of Endocrinology