Acquired thyroid-stimulating hormone, luteinizing hormone, and follicle-stimulating hormone deficiencies with circulating anti-glycoprotein hormones alpha chain-positive cell antibodies.

IF 3.7 3区 医学 Q2 Medicine
Endocrine Pub Date : 2024-11-01 Epub Date: 2024-06-21 DOI:10.1007/s12020-024-03922-0
Hironori Bando, Masaaki Yamamoto, Genzo Iguchi, Wataru Ogawa
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Abstract

Background: A patient with systemic lupus erythematosus (SLE) suffered from acquired thyroid-stimulating hormone (TSH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) deficiencies. MRI findings revealed a slight atrophy of the pituitary gland. Further, the serum concentration of the covalent alpha subunit (glycoprotein hormones alpha chain [CGA]) in TSH-, LH-, and FSH-positive cells was below the detectable range. Because SLE is an autoimmune disorder, autoimmunity against the pituitary gland was suspected as the cause of pituitary deficiency.

Methods and results: Immunofluorescence analysis showed that the patient's immunoglobulin G recognized CGA-positive cells in the pituitary gland; therefore, autoimmunity against CGA-positive cells may have caused TSH, LH, and FSH deficiencies in this patient. Moreover, cell-specific autoimmunity impairs pituitary hormone levels. Further research is required to clarify whether acquired TSH, LH, and FSH deficiencies are common in patients with SLE or other autoimmune diseases.

Conclusion: Our findings highlight a unique case of acquired TSH, LH, and FSH deficiencies caused by circulating anti-CGA-positive cell antibodies, introducing a novel clinical concept of acquired hypopituitarism.

Abstract Image

后天性促甲状腺激素、促黄体生成素和促卵泡激素缺乏症伴有循环抗糖蛋白激素α链阳性细胞抗体。
背景:一名系统性红斑狼疮(SLE)患者患有后天性促甲状腺激素(TSH)、促黄体生成素(LH)和促卵泡激素(FSH)缺乏症。核磁共振成像结果显示垂体轻微萎缩。此外,TSH、LH和FSH阳性细胞中共价α亚基(糖蛋白激素α链[CGA])的血清浓度低于可检测范围。由于系统性红斑狼疮是一种自身免疫性疾病,因此怀疑垂体自身免疫是导致垂体功能不足的原因:免疫荧光分析显示,患者的免疫球蛋白G能识别垂体中的CGA阳性细胞;因此,针对CGA阳性细胞的自身免疫可能是导致该患者TSH、LH和FSH缺乏的原因。此外,细胞特异性自身免疫也会损害垂体激素水平。要弄清获得性 TSH、LH 和 FSH 缺乏是否常见于系统性红斑狼疮或其他自身免疫性疾病患者,还需要进一步研究:我们的研究结果突显了一个由循环抗CGA阳性细胞抗体引起的获得性TSH、LH和FSH缺乏症的独特病例,引入了获得性垂体功能减退症的新临床概念。
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来源期刊
Endocrine
Endocrine 医学-内分泌学与代谢
CiteScore
6.40
自引率
5.40%
发文量
0
期刊介绍: Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.
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