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- Title
21-hydroxylase autoantibodies in adult patients with endocrine autoimmune diseases are highly specific for Addison's disease.
- Authors
Falorni, A.; Laureti, S.; Nikoshkov, A.; Picchio, M. L.; Hallengren, B.; Vandewalle, C. L.; Gorus, F. K.; Tortoioli, C.; H. Luthman; Brunhtti, P.; Santeusanio, F.
- Abstract
The diagnostic specificity of recombinant 21-hydroxylase autoantibodies (21OH-Ab) for Addison's disease was tested in adult patients with either Graves" disease (GD), insulin-dependent diabetes mellitus (IDDM), or polyendocrinopathy, as well as in healthy controls. Using a radiobinding assay with in vitro translated recombinant human 21-hydroxylase, we found 21OH-Ab in 24/28 (86%) idiopathic Addison patients, and using an immunofluorescence assay we found adrenal cortex autoantibodies (ACA) in 12/28 (43%) patients (P = 0.002). All the 12 ACA-positive sera were also positive for 21OHAb and ACA were found in 11/15 (73%) patients with less than 15 years and in 1/13 (8%) patients with 15-38 years of disease duration (P = 0.002). 21OH-Ab were present in 3/92 (3%) patients with GD. in 1/180 (0.6%) with IDDM and in 0/106 healthy subjects. The 2IOH-Ab-positive GD and IDDM patients were also positive for ACA. None of 17 patients with polyendocrinopathy, but without Addison's disease, had 2IOH-Ab. None of the 180 Belgian IDDM patients had Addison's disease or developed an adrenal insufficiency at follow up. In two out of three Graves patients, the presence of 21OH-Ab was associated with clinical and biochemical signs of adrenal insufficiency. Of the 89 21OH-Ab-negative patients with GD none had Addison's disease at the time of blood sampling, and 79 were followed up for 5.6-7.5 years and none developed clinical signs of adrenal insufficiency. We conclude that the presence of 21OH-Ab in patients with endocrine autoimmune diseases is highly, specific for Addison's disease.
- Subjects
AUTOANTIBODIES; ADDISON'S disease; AUTOIMMUNE diseases; AUTOIMMUNITY; HYPOGLYCEMIC agents; HYPOTHALAMIC-pituitary-adrenal axis; IMMUNOCYTOCHEMISTRY
- Publication
Clinical & Experimental Immunology, 1997, Vol 107, Issue 2, p341
- ISSN
0009-9104
- Publication type
Article
- DOI
10.1111/j.1365-2249.1997.262-ce1153.x