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The UF Health Pathology Laboratories' Endocrinology Laboratory makes autoantibody marker testing available for the following disorders:

William E. Winter, M.D., has been the Endocrinology Laboratory 's medical director since 1997. He was a research fellow of Noel K. Maclaren, M.D., the Lab's founder. Dr. Winter is a diplomate of the American Board of Clinical Chemistry and American Board of Pathology-certified in pediatrics, pediatric endocrinology and chemical pathology. He is also is the principal investigator for the islet cell autoantibody core laboratory for the NIH-funded study, "Type 1 Diabetes TrialNet."

Endocrinologists should request that their endocrine autoantibody testing be sent to the University of Florida because UF Health Pathology Laboratories:
  • Is licensed by CLIA, as well as the state of Florida, and accredited by the College of American Pathologists (CAP);
  • Features a team of pathologists with more than 25 years of experience working with autoantibody assays;
  • We are involved in major research trials using islet cell autoantibodies; and
  • We offer free consultations with our laboratory medical director, William E. Winter, M.D., who has extensive clinical and laboratory experience in the field of autoimmune endocrine disorders and who has published extensively on the topic of endocrine autoantibodies and autoimmune endocrine disorders.

Islet autoantibodies (a collective term for ICA, GADA, IA-2A and IAA), when positive, are diagnostic for type 1 diabetes. This may be helpful when a physician is unclear as to whether or not a patient with diabetes should be treated with insulin. Individuals with type 1 diabetes should be treated with insulin and not oral hypoglycemic agents. Islet autoantibodies in the absence of diabetes are highly predictive of the later development of type 1 diabetes. Such testing may be helpful in the lean patient with episodic hyperglycemia, impaired fasting glucose or impaired glucose tolerance when type 2 diabetes is unlikely.

Autoimmune thyroid disease is very common in the general population and even more so in people with type 1 diabetes. Finding either of the thyroid autoantibodies in the setting of goiter or hypothyroidism is usually diagnostic for Hashimoto thyroiditis. Identifying either of the thyroid autoantibodies in the setting of hyperthyroidism is usually diagnostic for Graves disease. Lastly, recognition of either of the thyroid autoantibodies in otherwise asymptomatic patients predicts an increased risk for subsequent thyroid disease (e.g., goiter, hypothyroidism or hyperthyroidism). Many experts advise yearly TSH testing in euthyroid patients with thyroid autoantibodies to anticipate the development of clinical thyroid disease. This can permit early treatment of thyroid disorders. Experts also advise that all patients with type 1 diabetes be screened for thyroid autoimmunity.

Identification of adrenal cytoplasmic autoantibodies in a patient with adrenal insufficiency establishes the diagnosis of autoimmune Addison disease. Autoimmune Addison disease is a key element in the diagnosis of either autoimmune polyglandular syndrome type 1 or type 2. Adrenal cytoplasmic autoantibodies in asymptomatic patients are predictive of the later development of Addison disease. Many experts advise yearly cortrosyn stimulation testing and renin measurements in this circumstance in anticipation of adrenal failure. This can allow early treatment of adrenal insufficiency.

Testing for steroidal cell autoantibodies uses 3 tissues: placenta, ovary and testes. In women with premature ovarian failure, positivity by indirect immunofluorescence on any of these substrates indicates an autoimmune etiology. Steroidal cell autoantibodies can be observed in the autoimmune polyglandular syndromes and can predict ovarian failure. Autoimmunity to the gonads is a common component of autoimmune polyglandular syndrome type 1.

While not an endocrine disorder, pernicious anemia is commonly associated with autoimmune endocrine disorders such as autoimmune thyroid disease and type 1 diabetes. Finding parietal cell autoantibodies in the setting of pernicious anemia is diagnostic for an autoimmune etiology (e.g., chronic lymphocytic gastritis). Parietal cell autoantibodies in asymptomatic patients are predictive of the later development of pernicious anemia. Many experts advise yearly vitamin B12 and ferritin testing in this circumstance. This can allow early treatment of pernicious anemia.