Abstract
The frequency of GH elevation observed in subjects with IDDM prompted us to look for pituitary autoantibodies. An indirect immunofluorescence technique utilizing human and guinea pig hypophysis was used to detect their presence in GH, TSH, and prolactin pituitary cells. Studies are now in progress to discriminate these specific endocrine cells autoantibodies. 26 subjects (12 boys, 14 girls, ages 7-20, mean age 12 ½ yr) were tested after TRH administration (7 μg/kg i.v., max, 200 μg). In controls, none had a significant response of plasma GH as defined by an increase to at least twice the baseline levels and greater than 5 ng/ml. In IDDM children, a significant GH elevation was observed in 17 of 26 cases (9 girls, 8 boys) with a mean ± SE level of 17.1 ± 2.9 ng/ml (range 7.2 - 39 ng/ml) (p<0.02 with normal). Among the responders to TRH, 14/17 had positive serum pituitary autoantibodies, while in the 9 children with no GH response to TRH, 7/9 had a negative determination. However, it is of interest to note that all patients except one had positive islet-cell antibodies in their serum.In conclusion, these results are in agreement with the known paradoxical response of GH after TRH in IDDM patients, but not with the lower incidence reported in adult females. In addition, the study of pituitary autoimmunity could partly explain the changes in GH secretion observed in IDDM patients.
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