Maghnie M, Lorini R, Vitali L, Mastricci N, Carrà A M, Severi F
Department of Paediatrics, University of Pavia, IRCCS Policlinico S. Matteo, Italy.
Eur J Pediatr. 1995 Jun;154(6):450-3. doi: 10.1007/BF02029353.
Serum non-organ-specific antibodies (NOSA) against nuclear, mitochondrial (AMA), smooth muscle, liver/kidney microsomal (LKM), reticulin, ribosomal, and organ-specific antibodies (OSA) against pituitary gland, gonads (testis, ovary) adrenal cortex, thyroid (thyroglobulin and microsomal), pancreas islet cells, gastric parietal cells and intestinal epithelial cells were evaluated in 45 patients with hypopituitarism (mean age 12.4 +/- 4.0 years). In 22 of them, 9 with isolated growth hormone (GH) deficiency (IGHD) and 13 with multiple pituitary hormone deficiency, MRI showed anterior pituitary hypoplasia with structural stalk abnormality and ectopic posterior pituitary. Twelve had isolated small anterior pituitary and IGHD and 11 had normal morphology of pituitary gland and IGHD. Controls were healthy age-sex-matched subjects. Thyroid antibodies were detected by a passive haemagglutination test while indirect immunofluorescence was used for the others. The auto-antibodies were found in 7/45 asymptomatic patients, a frequency not significantly different from that in controls; 5 were type NOSA and 2 type OSA. Pituitary antibodies were positive in 1 girl with IGHD and normal pituitary morphology. One girl developed hyperthyroidism during the follow up. Autoantibodies were equally distributed between the three groups and the frequency was not dissimilar from that in controls; this suggests that these patients are not at a higher risk of developing auto-immune disease, at least during the first two decades.
Pituitary insufficiency in children with different MRI features seems unlikely to be secondary to an auto-immune process.
在45例垂体功能减退患者（平均年龄12.4±4.0岁）中，评估了针对核、线粒体（抗线粒体抗体）、平滑肌、肝/肾微粒体（抗肝肾微粒体抗体）、网状纤维、核糖体的血清非器官特异性抗体（NOSA），以及针对垂体、性腺（睾丸、卵巢）、肾上腺皮质、甲状腺（甲状腺球蛋白和微粒体）、胰岛细胞、胃壁细胞和肠上皮细胞的器官特异性抗体（OSA）。其中22例，9例为孤立性生长激素（GH）缺乏（IGHD），13例为多种垂体激素缺乏，MRI显示垂体前叶发育不全伴结构柄异常和垂体后叶异位。12例有孤立性小垂体前叶和IGHD，11例垂体形态正常但有IGHD。对照组为年龄和性别匹配的健康受试者。甲状腺抗体通过被动血凝试验检测，其他抗体则采用间接免疫荧光法检测。在45例无症状患者中有7例检测到自身抗体，其频率与对照组无显著差异；5例为NOSA类型，2例为OSA类型。1例IGHD且垂体形态正常的女孩垂体抗体呈阳性。1例女孩在随访期间发生了甲状腺功能亢进。自身抗体在三组中分布均匀，其频率与对照组无差异；这表明这些患者至少在最初二十年中发生自身免疫性疾病的风险并不更高。
具有不同MRI特征的儿童垂体功能不全似乎不太可能继发于自身免疫过程。
