ASSOCIATED AUTOIMMUNITY IN ADDISONS-DISEASE

As the last extensive series of patients with Addison's disease and co incident autoimmune phenomena were published approximately two decades ago, we studied the cause of the disease, the prevalence of autoimmun e disorders and the frequency of occurrence of autoantibodies in 91 pa tients (31 men and 60 women, mean age 45.3-years-old, range 12-77) wit h Addison's disease. The cause of Addison's disease in six patients wa s tuberculosis (6.6%), and autoimmune adrenalitis was considered to be the cause in 83 patients (91.2%). In two patients (2.2%) other causes were responsible for Addison's disease. In 47% of the patients with a utoimmune Addison's disease at least one other autoimmune disorder was present. Primary hypothyroidism had the highest prevalence (20.5%), f ollowed by vitiligo (9.6%), non-toxic goiter (8.4%), premature menopau se (7.3% of the women), Graves' disease (6%), pernicious anaemia (4.8% ), Sjogren's disease (2.4%), hypoparathyroidism (1.2%), type 1 diabete s mellitus (1.2%) and coeliac disease (1.2%). The frequency of autoant ibodies in the patients with autoimmune Addison's disease was: adrenal antibodies (82.7%), antibodies against microsomal antigens (58%), thy roglobulin antibodies (23.4%), parietal cell antibodies (19.8%), pancr eatic islet cell antibodies (6.2%) and ovary antibodies (3.7% of the w omen). In comparison with other extensive series of patients with Addi son's disease, we found the highest prevalence of autoimmune adrenalit is as the cause of Addison's disease, the highest prevalence of hypoth yroidism and vitiligo as concomitant autoimmune disorders and the lowe st prevalence of type 1 diabetes mellitus.