II. Adrenal cortex and steroid 21-hydroxylase autoantibodies in children with organ-specific autoimmune diseases : Markers of high progression to clinical Addison's disease

Adrenal cortex autoantibodies (ACA) were measured by immunofluorescence in 808 children with organ-specific autoimmune diseases without adrenal insufficiency. ACA were found in 14 children (1.7%), mostly in hypoparathyroidism (48%). Ten ACA-positive and 12 ACA-negative children were followed up for...

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Veröffentlicht in:The journal of clinical endocrinology and metabolism 1997-03, Vol.82 (3), p.939-942
Hauptverfasser: BETTERLE, C, VOLPATO, M, SMITH, B. R, FURMANIAK, J, CHEN, S, ZANCHETTA, R, GREGGIO, N. A, PEDINI, B, BOSCARO, M, PRESOTTO, F
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container_end_page 942
container_issue 3
container_start_page 939
container_title The journal of clinical endocrinology and metabolism
container_volume 82
creator BETTERLE, C
VOLPATO, M
SMITH, B. R
FURMANIAK, J
CHEN, S
ZANCHETTA, R
GREGGIO, N. A
PEDINI, B
BOSCARO, M
PRESOTTO, F
description Adrenal cortex autoantibodies (ACA) were measured by immunofluorescence in 808 children with organ-specific autoimmune diseases without adrenal insufficiency. ACA were found in 14 children (1.7%), mostly in hypoparathyroidism (48%). Ten ACA-positive and 12 ACA-negative children were followed up for a maximum of 10 yr by evaluation of adrenocortical function (ACTH test) and autoantibody status. In all patients steroid-producing cell autoantibodies were assessed by immunofluorescence and autoantibodies to steroid 21-hydroxylase, 17 alpha-hydroxylase, and cytochrome P450 side-chain cleavage enzyme by immunoprecipitation assay. All 10 ACA-positive patients were positive for 21-hydroxylase autoantibodies. Six were positive for steroid-producing cell autoantibodies and 5 also for autoantibodies to 17 alpha-hydroxylase and/or P450 side-chain cleavage enzyme. Overt Addison's disease developed in 9 (90%) ACA/21-OH-antibody-positive children after 3-121 months, and 1 remaining child had subclinical hypoadrenalism. By contrast, all ACA/21-OH antibody-negative children maintained normal adrenal function. Adrenal failure was not related to ACA titres, sex, adrenal function, type of preexisting autoimmune disorder, or human leucocyte antigens D-related status. In conclusion, in children with autoimmune endocrine diseases, ACA/21-hydroxylase autoantibodies are important predictive markers for the development of Addison's disease.
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Adrenal cortex and steroid 21-hydroxylase autoantibodies in children with organ-specific autoimmune diseases : Markers of high progression to clinical Addison's disease</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Oxford University Press Journals All Titles (1996-Current)</source><creator>BETTERLE, C ; VOLPATO, M ; SMITH, B. R ; FURMANIAK, J ; CHEN, S ; ZANCHETTA, R ; GREGGIO, N. A ; PEDINI, B ; BOSCARO, M ; PRESOTTO, F</creator><creatorcontrib>BETTERLE, C ; VOLPATO, M ; SMITH, B. R ; FURMANIAK, J ; CHEN, S ; ZANCHETTA, R ; GREGGIO, N. A ; PEDINI, B ; BOSCARO, M ; PRESOTTO, F</creatorcontrib><description>Adrenal cortex autoantibodies (ACA) were measured by immunofluorescence in 808 children with organ-specific autoimmune diseases without adrenal insufficiency. ACA were found in 14 children (1.7%), mostly in hypoparathyroidism (48%). Ten ACA-positive and 12 ACA-negative children were followed up for a maximum of 10 yr by evaluation of adrenocortical function (ACTH test) and autoantibody status. In all patients steroid-producing cell autoantibodies were assessed by immunofluorescence and autoantibodies to steroid 21-hydroxylase, 17 alpha-hydroxylase, and cytochrome P450 side-chain cleavage enzyme by immunoprecipitation assay. All 10 ACA-positive patients were positive for 21-hydroxylase autoantibodies. Six were positive for steroid-producing cell autoantibodies and 5 also for autoantibodies to 17 alpha-hydroxylase and/or P450 side-chain cleavage enzyme. Overt Addison's disease developed in 9 (90%) ACA/21-OH-antibody-positive children after 3-121 months, and 1 remaining child had subclinical hypoadrenalism. By contrast, all ACA/21-OH antibody-negative children maintained normal adrenal function. Adrenal failure was not related to ACA titres, sex, adrenal function, type of preexisting autoimmune disorder, or human leucocyte antigens D-related status. In conclusion, in children with autoimmune endocrine diseases, ACA/21-hydroxylase autoantibodies are important predictive markers for the development of Addison's disease.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.82.3.939</identifier><identifier>PMID: 9062510</identifier><identifier>CODEN: JCEMAZ</identifier><language>eng</language><publisher>Bethesda, MD: Endocrine Society</publisher><subject>Addison Disease - etiology ; Adrenal Cortex - immunology ; Adrenals. Adrenal axis. 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Ten ACA-positive and 12 ACA-negative children were followed up for a maximum of 10 yr by evaluation of adrenocortical function (ACTH test) and autoantibody status. In all patients steroid-producing cell autoantibodies were assessed by immunofluorescence and autoantibodies to steroid 21-hydroxylase, 17 alpha-hydroxylase, and cytochrome P450 side-chain cleavage enzyme by immunoprecipitation assay. All 10 ACA-positive patients were positive for 21-hydroxylase autoantibodies. Six were positive for steroid-producing cell autoantibodies and 5 also for autoantibodies to 17 alpha-hydroxylase and/or P450 side-chain cleavage enzyme. Overt Addison's disease developed in 9 (90%) ACA/21-OH-antibody-positive children after 3-121 months, and 1 remaining child had subclinical hypoadrenalism. By contrast, all ACA/21-OH antibody-negative children maintained normal adrenal function. Adrenal failure was not related to ACA titres, sex, adrenal function, type of preexisting autoimmune disorder, or human leucocyte antigens D-related status. In conclusion, in children with autoimmune endocrine diseases, ACA/21-hydroxylase autoantibodies are important predictive markers for the development of Addison's disease.</description><subject>Addison Disease - etiology</subject><subject>Adrenal Cortex - immunology</subject><subject>Adrenals. Adrenal axis. Renin-angiotensin system (diseases)</subject><subject>Autoantibodies - analysis</subject><subject>Autoimmune Diseases - complications</subject><subject>Autoimmune Diseases - immunology</subject><subject>Biological and medical sciences</subject><subject>Biomarkers</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Disease Progression</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Non tumoral diseases. Target tissue resistance. 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Adrenal cortex and steroid 21-hydroxylase autoantibodies in children with organ-specific autoimmune diseases : Markers of high progression to clinical Addison's disease</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>1997-03</date><risdate>1997</risdate><volume>82</volume><issue>3</issue><spage>939</spage><epage>942</epage><pages>939-942</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><coden>JCEMAZ</coden><abstract>Adrenal cortex autoantibodies (ACA) were measured by immunofluorescence in 808 children with organ-specific autoimmune diseases without adrenal insufficiency. ACA were found in 14 children (1.7%), mostly in hypoparathyroidism (48%). Ten ACA-positive and 12 ACA-negative children were followed up for a maximum of 10 yr by evaluation of adrenocortical function (ACTH test) and autoantibody status. In all patients steroid-producing cell autoantibodies were assessed by immunofluorescence and autoantibodies to steroid 21-hydroxylase, 17 alpha-hydroxylase, and cytochrome P450 side-chain cleavage enzyme by immunoprecipitation assay. All 10 ACA-positive patients were positive for 21-hydroxylase autoantibodies. Six were positive for steroid-producing cell autoantibodies and 5 also for autoantibodies to 17 alpha-hydroxylase and/or P450 side-chain cleavage enzyme. Overt Addison's disease developed in 9 (90%) ACA/21-OH-antibody-positive children after 3-121 months, and 1 remaining child had subclinical hypoadrenalism. By contrast, all ACA/21-OH antibody-negative children maintained normal adrenal function. Adrenal failure was not related to ACA titres, sex, adrenal function, type of preexisting autoimmune disorder, or human leucocyte antigens D-related status. In conclusion, in children with autoimmune endocrine diseases, ACA/21-hydroxylase autoantibodies are important predictive markers for the development of Addison's disease.</abstract><cop>Bethesda, MD</cop><pub>Endocrine Society</pub><pmid>9062510</pmid><doi>10.1210/jc.82.3.939</doi><tpages>4</tpages></addata></record>
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subjects Addison Disease - etiology
Adrenal Cortex - immunology
Adrenals. Adrenal axis. Renin-angiotensin system (diseases)
Autoantibodies - analysis
Autoimmune Diseases - complications
Autoimmune Diseases - immunology
Biological and medical sciences
Biomarkers
Child
Child, Preschool
Disease Progression
Endocrinopathies
Female
Follow-Up Studies
Humans
Male
Medical sciences
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Organ Specificity
Prospective Studies
Steroid 21-Hydroxylase - immunology
title II. Adrenal cortex and steroid 21-hydroxylase autoantibodies in children with organ-specific autoimmune diseases : Markers of high progression to clinical Addison's disease
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