Longitudinal behavior of XXXX : from childhood to transition age.

@entity1 @entity2338 @entity792 @entity6126
BACKGROUND: Some cases of apparently @entity2338 ( @entity2338 ) may be caused by pituitary autoimmunity. OBJECTIVE: To study the variations in pituitary function and antipituitary antibodies (APA) from childhood to transition age in @entity1 with apparently idiopathic @entity2338 . DESIGN: We conducted a longitudinal study. @entity1 AND METHODS: Pituitary function and APA detection by immunofluorescence were investigated in 24 childhood @entity1 with @entity2338 before starting recombinant GH therapy and after the stopping of this therapy in transition age. Sera of @entity1 positive for APA were processed by double immunofluorescence to identify their pituitary target. RESULTS: At diagnosis, 16 out of 24 @entity1 were APA positive targeting only somatotrophs (group 1), while the remaining eight were APA negative (group 2). When retested off therapy, 12 out of 16 @entity1 in group 1 persisted being APA positive, while the remaining four became negative with recovery of pituitary function. All @entity1 in group 2 persisted being APA negative but still showing @entity2338 . Of the 12 @entity1 persistently APA positive, eight with confirmed @entity2338 showed APA still targeting somatotrophs, whereas four showed APA targeting only gonadotrophs associated with isolated @entity6126 ( @entity6126 ). CONCLUSION: @entity1 with APA at middle but not at high titer in childhood may show a remission of @entity792 in childhood after GH replacement therapy. As APA may shift their target in transition period, an early characterization of APA by double immunofluorescence is advisable in APA positive @entity2338 @entity1 showing delayed puberty, to allow an early diagnosis and an appropriate therapy, thus preventing the progression toward @entity6126 .
