title: [Seric 21-hydroxilase antibodies in patients with anti-microsomal fraction antibodies. Autoimmune polyendocrine syndrome].
abstract: Autoimmune polyendocrine syndrome (APS) is the association of autoimmune endocrine diseases, with other autoimmune nonendocrine disorders. APS types 1, 2 and 4 include autoimmune adrenalitis; this suggests the presence of autoantibodies. A specific serological marker for these is the anti 21- hydroxilase autoantibody (a21-OH). APS type 2 is the association of autoimmune adrenalitis, to autoimmune thyroid disease and/or diabetes mellitus, all these are induced by autoantibodies. Alopecia, vitiligo, myasthenia and other manifestations can be minor components. We sought to establish the prevalence of seric a21-OH in patients with positive anti-microsomal fraction autoantibodies, autoimmune thyroid disease and/or non-endocrine autoimmune diseases. We also aimed to diagnose incomplete forms of APS and to follow up patients at risk of progression to complete forms of APS. A population of 72 patients and another of 60 controls with negative anti-microsomal fraction autoantibodies were studied. Elevated seric a21-OH were found in two patients. Patient A with 47 U/ml had autoimmune hypothyroidism and myasthenia; and patient B with 8.75 U/ml had autoimmune hypothyrodism and vitiligo; they both lacked adrenal insufficiency. Seric a21-OH had a prevalence of 2.8%. Regarding the adrenal component, patients A and B had an incomplete and latent APS type 2. Considering a21-OH as markers of latent endocrine autoimmune diseases and taking into account the eventual risk of developing clinical manifestations, periodic biochemical and clinical follow-ups are recommended.
authors.affiliation: Departamento de Endocrinología Clínica, Instituto de Investigaciones Médicas A. Lanari, Universidad de Buenos Aires. sbotta@intramed.net
authors.forename: Silvia
authors.initials: S
authors.lastname: Botta
authors.forename: Silvana
authors.initials: S
authors.lastname: Roveto
authors.forename: Daniel
authors.initials: D
authors.lastname: Rimoldi
mesh_terms: D000293:Adolescent; D000309:Adrenal Insufficiency / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D015551:Autoimmunity; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016884:Polyendocrinopathies, Autoimmune / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D013255:Steroid 21-Hydroxylase / Q000097:blood*; D013577:Syndrome
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D013255:Steroid 21-Hydroxylase