Autoimmunity to anterior pituitary cells and the pathogenesis of insulin-dependent diabetes mellitus

Lancet. 1982 Apr 3;1(8275):755-9. doi: 10.1016/s0140-6736(82)91809-8.

Abstract

An immunofluorescence study using unfixed cryostat sections of human pituitary glands was carried out on sera from patients with type-Ia (juvenile-onset) diabetes (61 recent onset, 48 longstanding). 63 of their selected high-risk first-degree relatives and 117 patients with type-Ib ("polyendocrine") diabetes were tested for comparison. Healthy controls included 48 sera from laboratory staff and students. Pituitary-cell antibodies were found in none of the controls, in 2% of patients with longstanding diabetes, in 16.6% of patients with diabetes of recent onset, and in 36.6% of genetically predisposed relatives with islet-cell antibodies in their sera (of whom 7 became diabetic during a 3-year follow-up period, 4 of them reacting with pituitary cells for 1-3 years before the onset of diabetes). Thus pituitary antibodies tended to disappear after onset of symptoms. Many of the sera reacted with multiple anterior-pituitary cell types. These findings suggest a wider involvement of the endocrine-organ system in the pathogenesis of insulin-dependent diabetes and are in accordance with clinical observations showing excess growth in prepubertal boys at onset of diabetic symptoms and with the results of experiments on virus-induced diabetes in mice. The connection of these pituitary antibodies with autoimmune lymphocytic hypophysitis is at present unknown.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Autoantibodies / analysis*
  • Child
  • Child, Preschool
  • Complement Fixation Tests
  • Diabetes Mellitus, Type 1 / etiology*
  • Diabetes Mellitus, Type 1 / genetics
  • Diabetes Mellitus, Type 1 / immunology
  • Female
  • Fluorescent Antibody Technique
  • Histocompatibility Antigens Class II / genetics
  • Humans
  • Male
  • Pedigree
  • Pituitary Gland, Anterior / cytology
  • Pituitary Gland, Anterior / immunology*
  • Sex Factors

Substances

  • Autoantibodies
  • Histocompatibility Antigens Class II