title: [Addison's disease: principal clinical associations and description of natural history of the disease].
abstract: From 1967 to 1988 we studied 75 cases of Addison's disease (AD). An autoimmune etiology was found in 68%, while previous tubercular infection was demonstrated in 21% of the cases; minor causes were involved in 3%, and in 8% of the cases the disease remained of unknown origin. Autoimmune adrenalitis has become the most frequent cause of AD as a consequence of decreased tubercular infection. Autoimmune AD prevailed in children or in young people, and tubercular AD in adults. The finding of calcifications in adrenals and/or other organs was the specific diagnostic sign for the identification of tubercular forms. On the other hand, the finding of circulating adrenal autoantibodies (AA) and/or other organ specific autoantibodies was the fundamental diagnostic marker of autoimmune forms. In 72% of the cases autoimmune AD is associated with other organ-specific autoimmune diseases. Subjects with AA but without clinical signs of hypoadrenalism were considered to have "potential AD", because they showed a high risk of developing clinical hypoadrenalism. This condition develops over a long period characterized by different stages of subclinical adrenal hypofunction. Steroid cell autoantibodies (StCA) are frequently detectable in patients with autoimmune AD, in whom they are markers of autoimmune premature ovarian failure. The study of StCA-positive cases without hypogonadism will be important to clarify whether or not these autoantibodies could be markers of potential autoimmune hypogonadism.
authors.forename: C
authors.initials: C
authors.lastname: Betterle
authors.forename: C
authors.initials: C
authors.lastname: Scalici
authors.forename: B
authors.initials: B
authors.lastname: Pedini
authors.forename: F
authors.initials: F
authors.lastname: Mantero
mesh_terms: D000224:Addison Disease / Q000276:immunology / Q000503:physiopathology; D000293:Adolescent; D000304:Adrenal Cortex Function Tests; D000311:Adrenal Glands / Q000276:immunology / Q000503:physiopathology; D000328:Adult; D001323:Autoantibodies / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D001323:Autoantibodies
vernacular_title: Morbo di Addison: principali associazioni cliniche e descrizione della storia naturale della malattia.