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28.11.2016

Anti-pituitary antibodies against corticotrophs in IgG4-related hypophysitis

verfasst von: Naoko Iwata, Shintaro Iwama, Yoshihisa Sugimura, Yoshinori Yasuda, Kohtaro Nakashima, Seiji Takeuchi, Daisuke Hagiwara, Yoshihiro Ito, Hidetaka Suga, Motomitsu Goto, Ryoichi Banno, Patrizio Caturegli, Teruhiko Koike, Yoshiharu Oshida, Hiroshi Arima

Erschienen in: Pituitary | Ausgabe 3/2017

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Abstract

Purpose

IgG4-related disease is a systemic inflammatory disease characterized by infiltration of IgG4-positive plasma cells into multiple organs, including the pituitary gland. Autoimmunity is thought to be involved in the pathogenesis of IgG4-related disease. The diagnosis of IgG4-related hypophysitis (IgG4-RH) is difficult because its clinical features, such as pituitary swelling and hypopituitarism, are similar to those of other pituitary diseases, including lymphocytic hypophysitis and sellar/suprasellar tumors. The presence and significance of anti-pituitary antibodies (APA) in IgG4-RH is unclear.

Methods

In this case-control study, we used single indirect immunofluorescence on human pituitary substrates to assess the prevalence of serum APA in 17 patients with IgG4-RH, 8 control patients with other pituitary diseases (lymphocytic infundibulo-neurohypophysitis, 3; craniopharyngioma, 2; germinoma, 3), and 9 healthy subjects. We further analyzed the endocrine cells targeted by the antibodies using double indirect immunofluorescence.

Results

APA were found in 5 of 17 patients with IgG4-RH (29%), and in none of the pituitary controls or healthy subjects. The endocrine cells targeted by the antibodies in the 5 IgG4-RH cases were exclusively corticotrophs. Antibodies were of the IgG1 subclass, rather than IgG4, in all 5 cases, suggesting that IgG4 is not directly involved in the pathogenesis. Finally, antibodies recognized pro-opiomelanocortin in 2 of the cases.

Conclusions

Our study suggests that autoimmunity is involved in the pathogenesis of IgG4-RH and that corticotrophs are the main antigenic target, highlighting a possible new diagnostic marker for this condition.

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Titel: Anti-pituitary antibodies against corticotrophs in IgG4-related hypophysitis
verfasst von: Naoko Iwata
Shintaro Iwama
Yoshihisa Sugimura
Yoshinori Yasuda
Kohtaro Nakashima
Seiji Takeuchi
Daisuke Hagiwara
Yoshihiro Ito
Hidetaka Suga
Motomitsu Goto
Ryoichi Banno
Patrizio Caturegli
Teruhiko Koike
Yoshiharu Oshida
Hiroshi Arima
Publikationsdatum: 28.11.2016
Verlag: Springer US
Erschienen in: Pituitary / Ausgabe 3/2017
Print ISSN: 1386-341X
Elektronische ISSN: 1573-7403
DOI: https://doi.org/10.1007/s11102-016-0780-8

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Anti-pituitary antibodies against corticotrophs in IgG4-related hypophysitis

Abstract

Purpose

Methods

Results

Conclusions

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Parodontalbehandlung verbessert Prognose bei Katheterablation

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Purpose

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Results

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