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DEVELOPMENT OF ADRENOCORTICAL FAILURE IN NON‐ADDISONIAN PATIENTS WITH ANTIBODIES TO ADRENAL CORTEX A CLINICAL FOLLOW‐UP STUDY
Author(s) -
SCHERBAUM W. A.,
BERG P. A.
Publication year - 1982
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1982.tb00726.x
Subject(s) - medicine , adrenal cortex , subclinical infection , asymptomatic , euthyroid , thyroiditis , endocrinology , adrenal insufficiency , anti thyroid autoantibodies , thyroid , antibody , adrenocortical insufficiency , autoantibody , immunology
SUMMARY 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.