{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T19:11:29Z","timestamp":1767899489614,"version":"3.49.0"},"reference-count":42,"publisher":"The Endocrine Society","license":[{"start":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T00:00:00Z","timestamp":1626134400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Myalgic encephalomyelitis\/chronic fatigue syndrome (ME\/CFS) is a severe chronic illness that reduces the quality of life. A potential role of neuroendocrine autoimmune dysfunction has been hypothesized.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This work aims to investigate the occurrence of antipituitary (APA) and antihypothalamic (AHA) antibodies and possible related hypothalamic\/pituitary dysfunctions in ME\/CSF patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This is a case-control study conducted in a university hospital setting (Stanford, California, USA; and Naples, Italy). Thirty women with ME\/CSF (group 1) diagnosed according to Fukuda, Canadian, and Institute of Medicine criteria, at Stanford University, were enrolled and compared with 25 age-matched healthy controls. APA and AHA were detected by immunofluorescence; moreover, we investigated hormonal secretions of anterior pituitary and respective target glands. APA and AHA titers both were assessed and the prevalence of pituitary hormone deficiencies was also investigated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Patients in group 1 showed a high prevalence of AHA (33%) and APA (56%) and significantly lower levels of adrenocorticotropin (ACTH)\/cortisol, and growth hormone (GH) peak\/insulin-like growth factor-1 (IGF-1) vs controls (all AHA\/APA negative). Patients in group 1A (13 patients positive at high titers, \u2265\u20051:32) showed ACTH\/cortisol and GH peak\/IGF-1 levels significantly lower and more severe forms of ME\/CFS with respect to patients in group 1B (7 positive at middle\/low titers, 1:16-1:8) and 1C (10 antibody-negative patients).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Both AHA and\/or APA at high titers were associated with hypothalamic\/pituitary dysfunction, suggesting that hypothalamic\/pituitary autoimmunity may play an important role in the manifestations of ME\/CFS, especially in its more severe forms.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgab429","type":"journal-article","created":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T10:59:11Z","timestamp":1626173951000},"source":"Crossref","is-referenced-by-count":11,"title":["Hypothalamic-Pituitary Autoimmunity and Related Impairment of Hormone Secretions in Chronic Fatigue Syndrome"],"prefix":"10.1210","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0611-4506","authenticated-orcid":false,"given":"Annamaria","family":"De Bellis","sequence":"first","affiliation":[{"name":"Unit of Andrology, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"},{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Bellastella","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"},{"name":"Unit of Endocrinology and Metabolic Diseases, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vlenia","family":"Pernice","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Cirillo","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Longo","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"},{"name":"Unit of Endocrinology and Metabolic Diseases, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonietta","family":"Maio","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Scappaticcio","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Ida","family":"Maiorino","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"},{"name":"Unit of Endocrinology and Metabolic Diseases, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Bellastella","sequence":"additional","affiliation":[{"name":"University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Esposito","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"},{"name":"Unit of Diabetes, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 G","family":"Montoya","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases and Geographic Medicine; Institute for Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, California, 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