[Antipituitary antibodies in patients with suspected autoimmune hypophysitis].
BACKGROUND
Definitive diagnosis of autoimmune hypophysitis (AH) is histological. However, a presumptive diagnosis can be made through clinical, biochemical and imaging data.


OBJECTIVE
The objective of this study was to review the presence of antipituitary antibodies (APA) and antithyroid antibodies (ATA) in patients with suspected AH in order to determinate the utility of APA in the diagnosis of AH.


METHODS
We studied 36 patients divided into seven groups according to the data suggesting AH (isolated corticotropin deficiency, other idiopathic pituitary deficiencies, idiopathic hyperprolactinemia, empty sella, sellar mass with thickened stalk, proven histological hypophysitis) or because of previous autoimmune endocrine diseases. Twenty-four controls without endocrinological disease were also included. In all subjects, APA were determined by immunofluorescence over primate pituitary gland and ATA by an agglutination technique.


RESULTS
None of the controls and only 9 patients, all of them women, were APA-positive. Of the 9 APA-positive patients, 43% belonged to the group of patients with isolated ACTH deficiency. In 8 patients, APA were determined again during the follow-up; 6 remained APA-negative, but one patient became APA-positive and another became APA-negative. ATA were positive in 12 patients, 22.2% of whom were also APA-positive, and in one control.


CONCLUSIONS
The prevalence of APA positivity among the study patients was low. These antibodies were found only in women, mostly with isolated corticotropin deficiency. APA and ATA coexisted in only 22% of the patients studied.
Moya Chimenti
Elisa
E
Servicio de Endocrinología y Nutrición, Hospital Infanta Cristina, Madrid, España. emoyachimenti@gmail.com
Alvarez Doforno
Rita
R
Villaroel Bajo
Africa
A
Frutos
Remedios
R
Pallardo Sánchez
Luis Felipe
LF
Alvarez Escolá
Cristina
C
D000293:Adolescent; D000309:Adrenal Insufficiency / Q000209:etiology / Q000276:immunology; D000328:Adult; D000368:Aged; D000918:Antibody Specificity; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D001327:Autoimmune Diseases / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000209:etiology / Q000276:immunology; D007018:Hypopituitarism / Q000209:etiology / Q000276:immunology; D007249:Inflammation; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010900:Pituitary Diseases / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D010902:Pituitary Gland / Q000276:immunology* / Q000473:pathology; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000276:immunology; D055815:Young Adult
D001323:Autoantibodies