title: No evidence for autoimmunity as a major cause of the empty sella syndrome.
abstract: OBJECTIVE
  The cause of empty sella syndrome (ESS) remains largely unknown. We measured eleven organ-specific autoantibodies in serum in order to evaluate possible autoimmune components in ESS.
  
  
  METHODS
  Thirty patients with ESS and 50 healthy blood donors participated in the study.
  
  
  METHODS
  Detection of pituitary autoantibodies was performed by immunoblotting with human pituitary cytosol as antigen. Thyroid peroxidase (TPO) and TSH receptor (TRAK) autoantibodies were analysed by radioimmunoassay. The remaining eight autoantibodies were detected by in vitro transcription and translation of the autoantigens and immunoprecipitation.
  
  
  RESULTS
  The majority of the ESS patients (18/30) exhibited no immunoreactivity at all. None of the remaining 12 ESS patients reacted against more than one autoantigen. No immunoreactivity was found more frequently among ESS patients than healthy blood donors. Pituitary autoantibodies were not correlated to the ESS patients' pituitary function or sellar size, although the results indicated a tendency of increased autoimmunity in patients with hypopituitarism and normal sella size respectively.
  
  
  CONCLUSIONS
  Detection of autoantibodies is a valuable tool in the diagnostic work-up of autoimmune diseases. By analysing a large number of organ-specific autoantibodies we found no evidence of ESS being associated with any specific autoimmune disease. The pathogenesis of ESS is believed to be heterogeneous and our findings suggest autoimmune components to be of minor importance. In some selective cases, ESS in combination with hypopituitarism may be the result of an autoimmune disease in the pituitary gland but this needs further investigation.
authors.affiliation: Department of Molecular Medicine, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden. Sophie.Bensing@molmed.ki.se
authors.forename: S
authors.initials: S
authors.lastname: Bensing
authors.forename: F
authors.initials: F
authors.lastname: Rorsman
authors.forename: P
authors.initials: P
authors.lastname: Crock
authors.forename: C
authors.initials: C
authors.lastname: Sanjeevi
authors.forename: K
authors.initials: K
authors.lastname: Ericson
authors.forename: O
authors.initials: O
authors.lastname: Kämpe
authors.forename: K
authors.initials: K
authors.lastname: Brismar
authors.forename: A-L
authors.initials: AL
authors.lastname: Hulting
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D015551:Autoimmunity; D004652:Empty Sella Syndrome / Q000097:blood / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D008875:Middle Aged; D010902:Pituitary Gland / Q000276:immunology; D012016:Reference Values
chemical_list: D001323:Autoantibodies