RESUMEN
OBJECTIVE: Cytoplasmic autoantibodies to vasopressin cells (AVP) have been detected in patients with idiopathic central diabetes insipidus and only in one patient with endocrine autoimmune diseases without clinical diabetes insipidus. The aim of this study was to look for AVP cell antibodies (AVP-cell-Ab) in human sera of a large population of autoimmune endocrine disease patients without diabetes insipidus and to test whether an occurrence of these antibodies in some patients can be associated with partial impairment of posterior pituitary function. MEASUREMENT: Sera from 410 patients (310 females, 100 males, age range 10-46 years) with autoimmune endocrine disorders (260 with thyroid autoimmune disease, and 150 with insulin dependent diabetes mellitus) without clinical diabetes insipidus, and from 100 normal subjects, were investigated for hypothalamic autoantibodies by an indirect immunofluorescence method. Positive sera were subsequently tested with specific rabbit anti AVP serum. RESULTS: None of controls, but five out of 410 patients (1.2%) were AVP-cell-Ab positive. All positive and nine negative from the 410 screened patients were tested for posterior pituitary function. Two out of five AVP-cell-Ab positive patients showed partial diabetes insipidus. CONCLUSION: AVP cell antibodies can be shown in some patients with endocrine autoimmune disease without diabetes insipidus and can sometimes be associated with findings of partial posterior pituitary dysfunction. This suggests that clinical diabetes insipidus could be preceded by a long subclinical period characterized only by the occurrence of AVP-cell-Ab in the sera associated or followed by alterations in functional tests. Longitudinal studies are needed to confirm this hypothesis.
Asunto(s)
Arginina Vasopresina/inmunología , Autoanticuerpos/sangre , Enfermedades Autoinmunes/inmunología , Diabetes Mellitus Tipo 1/inmunología , Enfermedades de la Tiroides/inmunología , Adolescente , Adulto , Enfermedades Autoinmunes/fisiopatología , Niño , Diabetes Insípida/fisiopatología , Diabetes Mellitus Tipo 1/fisiopatología , Femenino , Técnica del Anticuerpo Fluorescente , Humanos , Hipotálamo/inmunología , Hipotálamo/fisiopatología , Masculino , Persona de Mediana Edad , Pruebas de Función Hipofisaria , Enfermedades de la Tiroides/fisiopatologíaRESUMEN
Authors report on a rare case of thyroid involvement by histiocytosis X. A 27-yr-old man with diabetes insipidus and lung bullous disease of 2 yr duration was found to have thyroid gland infiltration by differentiated histiocytosis X. This was based on cytological findings consistent with the diagnosis, obtained by fine needle aspiration biopsy. Endocrine studies revealed altered hypothalamic-pituitary function accounted for by a hypothalamic lesion.