Steroid-cell autoantibodies are preferentially expressed in women with premature ovarian failure who have adrenal autoimmunity.
OBJECTIVE
To determine the prevalence of steroid-cell autoantibodies, 3beta-hydroxysteroid dehydrogenase (3beta-HSD) antibodies, 17alpha-hydroxylase (17alpha-OH) antibodies, and P450 side-chain cleavage antibodies in premature ovarian failure.


METHODS
Cross-sectional, observational study.


METHODS
Academic research hospitals.


METHODS
Eighty-one women with premature ovarian failure, 20 women with Addison disease not associated with premature ovarian failure, 42 women with type 1 diabetes mellitus, and 90 healthy women.


METHODS
Serum levels of steroid-cell autoantibodies, 17alpha-OH antibodies, P450 side-chain cleavage antibodies, and 3beta-HSD antibodies.


RESULTS
Steroid-cell autoantibodies were present in none of 57 women with isolated premature ovarian failure or premature ovarian failure plus nonadrenal autoimmune disease and in 21 of 24 (87%) women with Addison disease-related premature ovarian failure. 17alpha-Hydroxylase antibodies and P450 side-chain cleavage antibodies were significantly more frequent in women positive for adrenal autoantibodies than in those negative for adrenal autoantibodies (50% vs. 0% and 71% vs. 2%, respectively). The presence of 17alpha-OH antibodies or P450 side-chain cleavage antibodies was strongly associated with presence of steroid-cell autoantibodies. Two of 24 (8%) women with Addison disease-related premature ovarian failure and 1 of 57 (2%) women with isolated premature ovarian failure or premature ovarian failure plus nonadrenal autoimmune disease were positive for 3beta-HSD antibodies. None of 20 adult women with autoimmune Addison disease and none of 42 adult women with type 1 diabetes mellitus not associated with premature ovarian failure was positive for 3beta-HSD antibodies.


CONCLUSIONS
Markers of steroid-cell autoimmunity are found only rarely in idiopathic premature ovarian failure not associated with Addison disease. Most women with Addison disease-related premature ovarian failure were positive for steroid-cell autoantibodies, 17alpha-OH antibodies, or P450 side-chain cleavage antibodies. 3beta-Hydroxysteroid dehydrogenase antibodies do not appear to be a major marker of steroid-cell autoimmunity.
Department of Internal Medicine, University of Perugia, Perugia, Italy. falorni@dimisen.med.unipg.it
Alberto
A
Falorni
Stefano
S
Laureti
Paola
P
Candeloro
Silvia
S
Perrino
Concetta
C
Coronella
Antonio
A
Bizzarro
Antonio
A
Bellastella
Fausto
F
Santeusanio
Annamaria
A
De Bellis
D015096:3-Hydroxysteroid Dehydrogenases / Q000276:immunology*; D000224:Addison Disease / Q000276:immunology; D000293:Adolescent; D000328:Adult; D001327:Autoimmune Diseases / Q000276:immunology; D015551:Autoimmunity / Q000502:physiology; D002786:Cholesterol Side-Chain Cleavage Enzyme / Q000276:immunology*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000276:immunology; D005260:Female; D006801:Humans; D016649:Primary Ovarian Insufficiency / Q000276:immunology*; D013254:Steroid 17-alpha-Hydroxylase / Q000276:immunology*
D015096:3-Hydroxysteroid Dehydrogenases; D013254:Steroid 17-alpha-Hydroxylase; D002786:Cholesterol Side-Chain Cleavage Enzyme