PRESENCE OF ANTI-PITUITARY HORMONE ANTIBODIES IN PATIENTS WITH EMPTY SELLA SYNDROME AND PITUITARY-TUMORS

OBJECTIVE We evaluated the presence of anti-pituitary hormone autoanti bodies (APHA) in patients with primary empty sella syndrome and pituit ary tumours and examined the correlation of positive antibodies with t he hormonal deficiencies. DESIGN Case-control, retrospective study. PA TIENTS Eleven patients were identified with primary empty sella syndro me or a pituitary tumour by magnetic resonance imaging or computed tom ography scanning. Six healthy, normal subjects without evidence of a p ituitary problem served as the control group. MEASUREMENTS Anti-pituit ary hormone autoantibodies against purified pituitary hormones were me asured in all subjects utilizing an immunoblotting technique. All pati ents with pituitary disease had their medical records reviewed for any hormonal evaluation. RESULTS All of the normal subjects were negative for antipituitary hormone antibodies. Forty-five per cent of patients with pituitary disease (pituitary tumours or primary empty sella synd rome) had positive antipituitary hormone antibodies. Of the five patie nts with positive antipituitary hormone antibodies, anti-ACTH antibodi es were the most common (5/5) followed by anti-TSH and anti-GH antibod ies (2/5 for each). The hormonal deficiencies failed to correspond wit h the antipituitary hormone antibodies. Anti-ACTH antibody had a sensi tivity of 50% with a specificity of 56%. The anti-TSH antibody yielded a sensitivity of 67% with a specificity of 100%. The anti-FSH/LH anti body reported a 0% sensitivity. CONCLUSIONS Detection of antipituitary hormone antibody was unable to discriminate between empty sella syndr ome and pituitary tumours. The presence of these antipituitary hormone antibodies were neither specific for, nor predictive of, the endocrin e deficiencies.