Current hypotheses include the hypothalamic dysfunction to be of autoimmune origin, due to the fact that antipituitary and antihypothalamus antibodies were identified in a patient with ROHHAD (84) and, more recently, the presence of anti-Zinc finger and SCAN domain containing 1 (ZSCAN1) antibodies were documented in patients with ROHHAD (85). This evidence concerns the gene ZSCAN1 and rapid-onset childhood obesity-hypothalamic dysfunction-hypoventilation-autonomic dysregulation syndrome.