Time course of 21-hydroxylase antibodies and long-term remission of subclinical autoimmune adrenalitis after corticosteroid therapy: case report
| Autor: | Gianfranco Abbate, Stefano Laureti, Silvia Perrino, Francesca Forini, Elio Bizzarro, Antonio Bellastella, Annamaria De Bellis, Antonio Bizzarro, Concetta Coronella, Alberto Falorni |
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| Přispěvatelé: | DE BELLIS, Annamaria, Falorni, A, Laureti, S, Perrino, S, Coronella, C, Forini, F, Bizzarro, E, Bizzarro, Antonio, Abbate, Gf, Bellastella, A., Abbate, G |
| Rok vydání: | 2001 |
| Předmět: |
Adrenal Cortex Diseases
Adult medicine.medical_specialty Time Factors Hydrocortisone medicine.drug_class Endocrinology Diabetes and Metabolism Graves' disease Clinical Biochemistry autoanticorpi Biochemistry Morbo di Addison prevenzione 21-idrossilasi immunoterapia Antibodies Autoimmune Diseases Endocrinology Adrenocorticotropic Hormone Adrenal Cortex Hormones Immunopathology Internal medicine medicine Adrenal insufficiency Humans Aldosterone Subclinical infection Autoimmune disease biology business.industry Biochemistry (medical) Autoantibody 21-Hydroxylase food and beverages medicine.disease eye diseases Graves Disease stomatognathic diseases biology.protein Corticosteroid Prednisone Female Steroid 21-Hydroxylase business Biomarkers Follow-Up Studies |
| Zdroj: | The Journal of clinical endocrinology and metabolism. 86(2) |
| ISSN: | 0021-972X |
| Popis: | Subclinical Addison's disease is characterized by the presence of adrenal autoantibodies (ACA) and steroid 21-hydroxylase autoantibodies (21OHAb) with or without adrenal function failure. In our previous longitudinal study some patients with high titers of ACA and at stage 2 of subclinical adrenocortical failure showed disappearance of ACA with recovery of normal adrenocortical function after corticosteroid treatment for Graves' ophthalmopathy. To investigate whether corticosteroid-induced modification of the adrenal autoimmune markers can also involve 21OHAb and to evaluate whether the remission of subclinical adrenocortical failure can persist over a long period of time, we followed-up for 100 months the levels of 21OHAb and ACA as well as the metabolic markers of adrenal function in one patient with Graves' ophthalmopathy and at stage 2 of subclinical adrenocortical failure before and after corticosteroid therapy. A 34-yr-old woman with Graves' disease and active ophthalmopathy who was found to be positive for ACA and to have high PRA, low aldosterone levels, and normal basal ACTH and cortisol levels, but impaired cortisol response to ACTH was studied. The patient was treated with oral corticosteroid therapy for 6 months. After corticosteroid therapy, 21OHAb, initially positive, became negative in concomitance with the disappearance of ACA and the restoration of normal adrenal function. The disappearance of both 21OHAb and ACA and their prolonged absence during the follow-up suggest that corticosteroid treatment can induce long-term remission of subclinical adrenal insufficiency and prevent the onset of the clinical phase of the disease. Our pilot study may pave the way to future trials aimed at preventing the onset of the clinical signs of Addison's disease in ACA/21OHAb-positive patients. |
| Databáze: | OpenAIRE |
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