白井 陽子
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Identification of Clinical Factors Related to Antibody-Mediated Immune Response to the Subfornical Organ.
Journal Formal name:Clinical endocrinology
Abbreviation:Clin Endocrinol (Oxf)
ISSN code:13652265/03000664
Domestic / ForeginForegin
Volume, Issue, Page 1(1),pp.1-9
Author and coauthor Nakamura-Utsunomiya Akari, Goda Satoshi, Hayakawa Seiichi, Sonoko Sakata, Hoorn Ewout J, Blanchard Anne, Saito-Hakoda Akiko, Kakimoto Haruna, Hachiya Rumi, Kamimura Miki, Kawakita Rie, Higuchi Shinji, Fujimaru Rika, Shirai Yoko, Miyaoka Daichi, Nagata Yuki, Kishi Yutaro, Wada Aya, Mitsuboshi Akari, Ozaki Kayo, Komatsu Nagisa, Niizuma Hidetaka, Kanno Junko, Fujiwara Ikuma, Hasegawa Yukihiro, Yorifuji Tohru, Brickman Wendy, Vantyghem Marie-Christine, Yamaguchi Kei, Goshima Naoki, Hiyama Takeshi Y
Publication date 2022/04
Summary OBJECTIVE:We recently reported cases of adipsic hypernatremia caused by autoantibodies against the subfornical organ in patients with hypothalamic-pituitary lesions. This study aimed to clarify the clinical features of newly identified patients with adipsic hypernatremia whose sera displayed immunoreactivity to the mouse subfornical organ.DESIGN:Observational cohort study of patients diagnosed with adipsic hypernatremia in Japan, USA, and Europe METHODS: The study included 22 patients with adipsic hypernatremia but without overt structural changes in the hypothalamic-pituitary region and congenital disease. Antibody response to the mouse subfornical organ was determined using immunohistochemistry. The clinical characteristics were compared between the patients with positive and negative antibody responses.RESULTS:Antibody response to the mouse subfornical organ was detected in the sera of 16 patients (72.7%, female/male ratio, 1:1, 12 pediatric and 4 adult patients). The prolactin levels at the time of diagnosis were significantly higher in patients with positive subfornical organ (SFO) immunoreactivity than in those with negative SFO immunoreactivity (58.9 ± 33.5 vs. 22.9 ± 13.9 ng/mL, p < 0.05). Hypothalamic disorders were found in 37.5 % of the patients with positive SFO immunoreactivity. Moreover, six patients were diagnosed with rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation/neural tumor syndrome after the diagnosis of adipsic hypernatremia. Plasma renin activity levels were significantly higher in patients with serum immunoreactivity to the Nax channel.CONCLUSIONS:The patients with serum immunoreactivity to the SFO had higher prolactin levels and hypothalamic disorders compared to those without the immunoreactivity. The clinical characteristics of patients with serum immunoreactivity to the subfornical organ included higher prolactin levels and hypothalamic disorders, which were frequently associated with centra
DOI 10.1111/cen.14737
PMID 35419873