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Submitted on January 9, 2006
Accepted on April 7, 2006
Chair of Endocrinology - Department of Clinical and Experimental Medicine and Surgery "F. Magrassi, A. Lanzara", Second University of Naples, Italy, Department of Pediatrics Federico II University, Naples, Italy
* To whom correspondence should be addressed. E-mail: annamaria.debellis{at}unina2.it.
Context: Antipituitary antibodies (APA) recognizing GH-secreting cells may indicate an autoimmune pituitary involvement in adults with idiopathic GH deficiency (IGHD).
Objective: We aimed 1) to investigate the presence of APA in prepubertal children with idiopathic GHD or idiopathic short stature (ISS), identifying the pituitary hormone-producing cells targeted by APA, 2) to verify whether in patients with ISS, the presence of APA could predict the development of GHD.
Design: We performed a cross-sectional and partially longitudinal cohort study.
Setting: The study was performed at the Endocrinology Unit and Pediatric Unit of 2nd University and University Federico II of Naples, respectively.
Patients: Twenty-six children with IGHD (group 1), 60 children with ISS (group 2) and 33 children with GHD due to lesions/abnormalities of hypothalamus or pituitary (group 3) and 40 controls participated in the study. Nineteen children of group 2 were re-evaluated after 2 yr.
Main outcome measures: IGF-I levels, GH secretion and APA (by indirect immunofluorescence) were evaluated in all participants .
Results: At study entry, APA recognizing GH-producing cells were detected in 7 out of 26 children of group 1 and in 14 out of 60 of group 2. Two years later, all 8 initially APA positive and all 11 APA negative of the 19 reevaluated patients persisted positive and negative, respectively. The re-evaluation of GH secretion in these patients revealed the development of GHD in all but one APA positive children, while in none of APA negative ones.
Conclusions: IGHD in children can be frequently associated with APA targeting GH-secreting cells, thus the detection of APA in children with ISS could identify those prone to develop GHD.
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