PURPOSE: Detection of antipituitary antibodies (APA) at high levels and with a particular immunofluorescence pattern in patients with autoimmune polyendocrine syndromes may indicate a possible future autoimmune pituitary involvement. This longitudinal study was aimed at characterizing in patients with a single organ-specific autoimmune disease the pituitary cells targeted by APA at start, verifying whether this characterization allows to foresee the kind of possible subsequent hypopituitarism. METHODS: Thirty-six APA positive and 40 APA negative patients with isolated autoimmune diseases participated in the study. None of them had pituitary dysfunction at entry. Characterization by four-layer immunofluorescence of pituitary cells targeted by APA in APA positive patients at entry and study of pituitary function in all patients were performed every 6 months during a 5 year follow-up. RESULTS: Antipituitary antibodies immunostained selectively one type of pituitary-secreting cells in 21 patients (58.3 %, group 1), and several types of pituitary cells in the remaining 15 (41.7 %, group 2). All patients in group 1 showed subsequently a pituitary insufficiency, corresponding to the type of cells targeted by APA in 18 of them (85.7 %). Only 8 out of 15 patients in group 2 (53.3 %) showed a hypopituitarism, isolated in 7 and combined in the other one. None of APA negative patients showed hypopituitarism. CONCLUSIONS: The characterization of pituitary cells targeted by APA in patients with isolated autoimmune diseases, when the pituitary function is still normal, may help to foresee the kind of subsequent hypopituitarism, especially when APA immunostained selectively only one type of pituitary cells. A careful follow-up of pituitary function in these patients is advisable to allow an early diagnosis of hypopituitarism, even in subclinical phase and a consequent timely replacement therapy.
PURPOSE: Detection of antipituitary antibodies (APA) at high levels and with a particular immunofluorescence pattern in patients with autoimmune polyendocrine syndromes may indicate a possible future autoimmune pituitary involvement. This longitudinal study was aimed at characterizing in patients with a single organ-specific autoimmune disease the pituitary cells targeted by APA at start, verifying whether this characterization allows to foresee the kind of possible subsequent hypopituitarism. METHODS: Thirty-six APA positive and 40 APA negative patients with isolated autoimmune diseases participated in the study. None of them had pituitary dysfunction at entry. Characterization by four-layer immunofluorescence of pituitary cells targeted by APA in APA positive patients at entry and study of pituitary function in all patients were performed every 6 months during a 5 year follow-up. RESULTS: Antipituitary antibodies immunostained selectively one type of pituitary-secreting cells in 21 patients (58.3 %, group 1), and several types of pituitary cells in the remaining 15 (41.7 %, group 2). All patients in group 1 showed subsequently a pituitary insufficiency, corresponding to the type of cells targeted by APA in 18 of them (85.7 %). Only 8 out of 15 patients in group 2 (53.3 %) showed a hypopituitarism, isolated in 7 and combined in the other one. None of APA negative patients showed hypopituitarism. CONCLUSIONS: The characterization of pituitary cells targeted by APA in patients with isolated autoimmune diseases, when the pituitary function is still normal, may help to foresee the kind of subsequent hypopituitarism, especially when APA immunostained selectively only one type of pituitary cells. A careful follow-up of pituitary function in these patients is advisable to allow an early diagnosis of hypopituitarism, even in subclinical phase and a consequent timely replacement therapy.
Authors: Giuseppe Bellastella; Mario Rotondi; Elena Pane; Assunta Dello Iacovo; Barbara Pirali; Liliana Dalla Mora; Alberto Falorni; Antonio Agostino Sinisi; Antonio Bizzarro; Annamaria Colao; Luca Chiovato; Annamaria De Bellis Journal: J Clin Endocrinol Metab Date: 2010-05-25 Impact factor: 5.958
Authors: Sophie Bensing; Sergueï O Fetissov; Jan Mulder; Jaakko Perheentupa; Jan Gustafsson; Eystein S Husebye; Mikael Oscarson; Olov Ekwall; Patricia A Crock; Tomas Hökfelt; Anna-Lena Hulting; Olle Kämpe Journal: Proc Natl Acad Sci U S A Date: 2007-01-10 Impact factor: 11.205
Authors: A De Bellis; A Bizzarro; R Rossi; V A Paglionico; T Criscuolo; G Lombardi; A Bellastella Journal: J Clin Endocrinol Metab Date: 1993-04 Impact factor: 5.958
Authors: Annamaria De Bellis; Elena Pane; Giuseppe Bellastella; Antonio A Sinisi; Caterina Colella; Roberta Giordano; Claudia Giavoli; Andrea Lania; Maria R Ambrosio; Carolina Di Somma; Maria C Zatelli; Emanuela Arvat; Annamaria Colao; Antonio Bizzarro; Antonio Bellastella Journal: Clin Endocrinol (Oxf) Date: 2011-09 Impact factor: 3.478
Authors: Annamaria De Bellis; Giuseppe Bellastella; Maria Ida Maiorino; Angela Costantino; Paolo Cirillo; Miriam Longo; Vlenia Pernice; Antonio Bellastella; Katherine Esposito Journal: Pituitary Date: 2019-06 Impact factor: 4.107
Authors: C Pisanu; C Cocco; E Cossu; M G Baroni; F Pigliaru; L Manetti; I Lupi; E Martino; S Mariotti Journal: J Endocrinol Invest Date: 2014-07-29 Impact factor: 4.256
Authors: Giuseppe Bellastella; Maria Ida Maiorino; Miriam Longo; Paolo Cirillo; Lorenzo Scappaticcio; Maria Teresa Vietri; Antonio Bellastella; Katherine Esposito; Annamaria De Bellis Journal: Int J Mol Sci Date: 2020-02-19 Impact factor: 5.923
Authors: Giuseppe Bellastella; Maria Ida Maiorino; Antonio Bizzarro; Dario Giugliano; Katherine Esposito; Antonio Bellastella; Annamaria De Bellis Journal: Pituitary Date: 2016-12 Impact factor: 4.107