Secretion of Anterior Pituitary Hormones in Patients with Insulin-Dependent Diabetes Mellitus and Polyglandular Autoimmune Syndrome.

Kurokawa, Hisayo; Numata, Yukiko; Nishioka, Tatsuya; Takao, Toshihiro; Hashimoto, Kozo

doi:10.2169/internalmedicine.35.686

Cited by 3 publications

(3 citation statements)

References 31 publications

(19 reference statements)

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“…In approximately 20% of cases of autoimmune hypophysitis, other autoimmune diseases co‐exists most commonly thyroid disease. Possible mechanism for GHD may involve selective loss of somatotrophs from targeted autoimmune aggression (13, 15) or gammaglobulins that have inhibitory effect on anterior pituitary hormone secretion (18).…”

Section: Discussionmentioning

confidence: 99%

Autoimmune polyglandular syndrome Type 3 and growth hormone deficiency

et al. 2010

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The simultaneous occurrence of prepubertal Graves' disease, type 1 Diabetes Mellitus (DM), and Growth hormone deficiency (GHD) is uncommon. GHD has been reported in Autoimmune Polyglandular Syndrome (APS) Type 1 and Type 2 but not in APS Type 3. We report a 3-yr-old boy who presented simultaneously with type 1 DM and Graves' disease. After he developed urticarial rash to Propylthiouracil and Methimazole with persistent thyrotoxicosis, he received 8 millicuries of (131)I at 5 yr of age. We diagnosed GHD at age 8 yr 8 months because of growth deceleration (from 95 to 25%) and abnormal growth rate (3 cm/yr) despite euthyroidism, fair glycemic control, and normal weight gain. Both insulin-like growth factor (IGF) 1 (90 ng/mL; normal 113-261 ng/mL) and IGFBP3 (1.3 mcg/mL; normal 2.1-4.2 mcg/mL) levels were low and peak growth hormone level measured by RIA was 5.2 ng/mL after L-Dopa and insulin tolerance test. The rest of his pituitary functions and magnetic resonance imaging of the pituitary gland were normal. Growth hormone treatment (0.3 mg/kg/wk) was administered at 8 yr 9 months until near final adult height (FAH). Near FAH (172 cm) was close to midparental target height of 180 cm. GHD may be a component of all APS even though it is rare. Growth in treated children with Graves' disease should be followed closely as catch down growth below genetic height potential may be a harbinger of underlying GHD.

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Section: Discussionmentioning

confidence: 99%

Autoimmune polyglandular syndrome Type 3 and growth hormone deficiency

et al. 2010

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“…Ovarian failure is more frequent than testicular dysfunction (Neufeld et al, 1981;Nerup, 1974;Trence et al, 1984). Involvement of the pituitary gland is occasionally seen in APS-2 (Kurokawa et al, 1996). Hypophysitis and empty sella syndrome have been described leading to isolated failure of secretion of growth hormone (GH), adrenocorticotropin (ACTH), thyrotropin (TSH), follicle-stimulating hormone (FSH), or luteinizing hormone (LH) (Kurokawa et al,1996;Belvisi et al,1993;Barkan et al, 1985;Ozawa and Shishiba, 1995).…”

Section: Introductionmentioning

confidence: 99%

“…Involvement of the pituitary gland is occasionally seen in APS-2 (Kurokawa et al, 1996). Hypophysitis and empty sella syndrome have been described leading to isolated failure of secretion of growth hormone (GH), adrenocorticotropin (ACTH), thyrotropin (TSH), follicle-stimulating hormone (FSH), or luteinizing hormone (LH) (Kurokawa et al,1996;Belvisi et al,1993;Barkan et al, 1985;Ozawa and Shishiba, 1995). Nonendocrine disorders, such as vitiligo, myasthenia gravis, immune thrombocytopenia purpura, Sjogrens syndrome, rheumatoid arthritis (Neufeld et al, 1981;Trence et al, 1984), pernicious anemia, ulcerative colitis (Govindarajan and Galpin, 1992), primary billiary cirrhosis (Ko et al, 1996), sarcoidosis (Watson and Lewis, 1996), or cerebellitis (Saiz et al, 1997;Solimena et al, 1998;Ruegg et al, 2002) occur occasionally.…”

Section: Introductionmentioning

confidence: 99%

Autoimmune Polyglandular Syndrome Associated with Idiopathic Giant Cell Myocarditis

Schumann

Faust

Gerharz

et al. 2005

Exp Clin Endocrinol Diabetes

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The autoimmune polyglandular syndrome (APS) is characterized by a variable coexistence of several autoimmune diseases, affecting predominantly endocrine glands. In general two types of APS are distinguished. Type 1 APS is an autosomal recessive disorder often leading to insufficiency of the adrenal cortex, the parathyroid glands, and/or the gonads. This type of APS often affects the skin in form of chronic mucocutaneous candidiasis and ectodermal dystrophies (vitiligo, alopecia, keratopathy, dystrophy of dental enamel and nails). The second form of APS is a polygenic disease which usually involves the adrenal gland, the thyroid and the pancreatic beta-cells. In rare cases APS type 2 is associated with myasthenia gravis, autoimmune thrombocytopenic purpura, Sjogren's syndrome or rheumatoid arthritis. Here we describe a case of APS with the unusual combination of type 1 diabetes, secondary adrenocortical insufficiency, growth hormone deficiency, and primary hypothyroidism associated with lethal idiopathic giant cell myocarditis. The combination of APS and idiopathic giant cell myocarditis which is a rare, frequently fatal autoimmune disorder of myocardium affecting most commonly young individuals has not been reported so far.

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Autoimmune polyglandular syndrome II: clinical syndrome and treatment

Schatz

Winter

2002

Endocrinology and Metabolism Clinics of North America

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Secretion of Anterior Pituitary Hormones in Patients with Insulin-Dependent Diabetes Mellitus and Polyglandular Autoimmune Syndrome.

Cited by 3 publications

References 31 publications

Autoimmune polyglandular syndrome Type 3 and growth hormone deficiency

Autoimmune polyglandular syndrome Type 3 and growth hormone deficiency

Autoimmune Polyglandular Syndrome Associated with Idiopathic Giant Cell Myocarditis

Autoimmune polyglandular syndrome II: clinical syndrome and treatment

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