BACKGROUND: Circulating antipituitary antibodies (APA) are markers of autoimmune hypophysitis, which may cause deficient pituitary function. The prevalence of APA in autoimmune thyroid disorders (AITD) is uncertain. OBJECTIVES: The aims of this study were 1) to evaluate APA prevalence in a large series of patients with AITD and non-AITD and 2) to investigate the functional significance of APA by assessing pituitary function in APA-positive patients. DESIGN AND SETTING: We conducted a health survey on consecutive AITD and non-AITD patients at a tertiary referral center (Department of Endocrinology, Pisa). PATIENTS: Subjects, including 1290 consecutive patients with thyroid disorders (961 AITD and 329 non-AITD) and 135 controls, were enrolled in the study. METHODS: APA (indirect immunofluorescence), free T(4), free T(3), TSH, and organ-specific autoantibodies were assayed in all patients. Functional pituitary evaluation was performed in most APA-positive patients. RESULTS: APA frequency was higher in AITD (11.4%) than in non-AITD (0.9%; P < 0.0001) patients; all control subjects had negative APA tests. APA were more frequently found in Hashimoto's thyroiditis (13%) than in Graves' disease (7.1%; P = 0.05). Of 110 APA-positive AITD patients, 20 (18.2%) had autoimmune polyglandular syndrome, whereas 90 (81.8%) had apparently isolated AITD. APA positivity increased percentage of autoimmune polyglandular syndrome in our series from 10.4 to 13.5%. Of 110 APA-positive patients, 102 were submitted to dynamic testing for functional pituitary assessment; 36 patients (35.2%) had mild or severe GH deficiency (GHD). No additional anterior pituitary hormone deficiencies were found; one patient had central diabetes insipidus. Pituitary abnormalities at magnetic resonance imaging were found in most APA-positive GHD patients. CONCLUSIONS: APA are frequently present in patients with AITD. Patients should be tested for APA because positive tests are associated with GHD.
BACKGROUND: Circulating antipituitary antibodies (APA) are markers of autoimmune hypophysitis, which may cause deficient pituitary function. The prevalence of APA in autoimmune thyroid disorders (AITD) is uncertain. OBJECTIVES: The aims of this study were 1) to evaluate APA prevalence in a large series of patients with AITD and non-AITD and 2) to investigate the functional significance of APA by assessing pituitary function in APA-positive patients. DESIGN AND SETTING: We conducted a health survey on consecutive AITD and non-AITD patients at a tertiary referral center (Department of Endocrinology, Pisa). PATIENTS: Subjects, including 1290 consecutive patients with thyroid disorders (961 AITD and 329 non-AITD) and 135 controls, were enrolled in the study. METHODS: APA (indirect immunofluorescence), free T(4), free T(3), TSH, and organ-specific autoantibodies were assayed in all patients. Functional pituitary evaluation was performed in most APA-positive patients. RESULTS: APA frequency was higher in AITD (11.4%) than in non-AITD (0.9%; P < 0.0001) patients; all control subjects had negative APA tests. APA were more frequently found in Hashimoto's thyroiditis (13%) than in Graves' disease (7.1%; P = 0.05). Of 110 APA-positive AITD patients, 20 (18.2%) had autoimmune polyglandular syndrome, whereas 90 (81.8%) had apparently isolated AITD. APA positivity increased percentage of autoimmune polyglandular syndrome in our series from 10.4 to 13.5%. Of 110 APA-positive patients, 102 were submitted to dynamic testing for functional pituitary assessment; 36 patients (35.2%) had mild or severe GH deficiency (GHD). No additional anterior pituitary hormone deficiencies were found; one patient had central diabetes insipidus. Pituitary abnormalities at magnetic resonance imaging were found in most APA-positive GHD patients. CONCLUSIONS: APA are frequently present in patients with AITD. Patients should be tested for APA because positive tests are associated with GHD.
Authors: M Guitelman; Natalia Garcia Basavilbaso; M Vitale; A Chervin; D Katz; K Miragaya; J Herrera; D Cornalo; M Servidio; L Boero; M Manavela; K Danilowicz; A Alfieri; G Stalldecker; M Glerean; P Fainstein Day; C Ballarino; Maria Susana Mallea Gil; A Rogozinski Journal: Pituitary Date: 2013-06 Impact factor: 4.107
Authors: I Lupi; L Manetti; V Raffaelli; M Lombardi; M Cosottini; A Iannelli; F Basolo; A Proietti; F Bogazzi; P Caturegli; E Martino Journal: J Endocrinol Invest Date: 2011-07-12 Impact factor: 4.256
Authors: F Bogazzi; M Lombardi; E Strata; G Aquaro; M Lombardi; C Urbani; V Di Bello; C Cosci; C Sardella; E Talini; E Martino Journal: J Endocrinol Invest Date: 2010-02 Impact factor: 4.256
Authors: Antonio Bianchi; Marilda Mormando; Francesco Doglietto; Linda Tartaglione; Serena Piacentini; Libero Lauriola; Giulio Maira; Laura De Marinis Journal: Pituitary Date: 2014-06 Impact factor: 4.107
Authors: I Lupi; V Raffaelli; G Di Cianni; P Caturegli; L Manetti; A M Ciccarone; F Bogazzi; S Mariotti; S Del Prato; E Martino Journal: J Endocrinol Invest Date: 2013-02 Impact factor: 4.256
Authors: Eugen Melcescu; Reed B Hogan; Keith Brown; Stewart A Boyd; Thomas L Abell; Christian A Koch Journal: Exp Mol Pathol Date: 2012-10-05 Impact factor: 3.362