Development of adrenocortical failure in non-Addisonian patients with antibodies to adrenal cortex. A clinical follow-up study.
Out of 1036 sera tested for the presence of antibodies to adrenal cortex using the indirect immunofluorescence (IFL) method, fifteen out of 323 patients with Graves' thyrotoxicosis, 6/105 Hashimoto's thyroiditis, 3/29 myxoedema, 2/49 asymptomatic autoimmune thyroiditis, 1/12 subacute thyroiditis, and 4/130 with myasthenia gravis were positive. Thirty antibody-positive non-addisonian patients were tested for subclinical adrenocortical failure and followed up over a period of 1-3.5 years. Three women with Graves' disease had biochemical signs of early Addison's disease at the first Synacthen test. Two young women with controlled Graves' thyrotoxicosis developed a diminished adrenocortical reserve within 2 and 3 years, respectively; one of them developed anovulatory cycles which did not respond to clomiphene treatment. Both patients had high titres of complement-fixing adrenal antibodies before the adrenal failure could be recognized by functional tests. One elderly female patient in whom a euthyroid goitre with adrenal and thyroid antibodies was detected in 1977, developed Graves' thyrotoxicosis in 1980. These observations indicate that antibodies to adrenal cortex have a high clinical significance and may allow the early diagnosis of Addison's disease even in the absence of specific clinical symptoms.
D000224:Addison Disease / Q000276:immunology; D000302:Adrenal Cortex / Q000276:immunology*; D000307:Adrenal Gland Diseases / Q000276:immunology*; D000906:Antibodies / Q000032:analysis*; D005500:Follow-Up Studies; D006111:Graves Disease / Q000276:immunology; D006801:Humans; D009157:Myasthenia Gravis / Q000276:immunology; D009230:Myxedema / Q000276:immunology; D013959:Thyroid Diseases / Q000276:immunology*; D013966:Thyroiditis / Q000276:immunology; D013967:Thyroiditis, Autoimmune / Q000276:immunology
D000906:Antibodies