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PubMed1994

Myasthenia gravis associated with Addison's disease.

Idiopathic Addison's disease developed in a 52-year-old female with a 15-year history of myasthenia gravis. The association of myasthenia gravis with other autoimmune diseases is well known, however an association with Addison's disease is rare. It was speculated that the development of Addison's disease in this patient might have been due to common immunological abnormalities underlying these two diseases. We report this case and briefly discuss the pathogenetic mechanism of this association.

Addison Disease↗
PubMed1953

ADDISON'S disease.

Explore the source record for details and available documents.

Addison Disease↗
PubMed1992

T and B cell reactivity to adrenal antigens in autoimmune Addison's disease.

Autoimmune Addison's disease is a rare condition of uncertain pathogenesis. To delineate potential autoantigens, an adrenal homogenate was fractioned by SDS-gel electrophoresis and used in immunoblotting and T cell proliferation assays. Antibodies specific for adrenal proteins with approximate molecular weights of 70, 55 and 45 were found in five out of 20 consecutive Addison's disease patients at routine follow-up. Five sera also reacted with a 52-kD protein shared with liver. T cells from six out of 10 Addison's disease patients proliferated in response to a range of adrenal-specific antigens including one, in particular, with a molecular weight of 18-24 kD. T and B cell reactivity to adrenal antigens did not appear to correlate and there was no relationship with time since diagnosis, associated autoimmunity or HLA-DR type. These results show that the autoimmune response to adrenal antigens in Addison's disease is heterogeneous and that such autoreactivity can only be inconsistently documented using these techniques and circulating antibodies or T cells.

Addison Disease↗
PubMed2002

Preliminary evidence that an endogenous retroviral long-terminal repeat (LTR13) at the HLA-DQB1 gene locus confers susceptibility to Addison's disease.

OBJECTIVE: Addison's disease is associated with particular haplotypes of the human leucocyte antigen (HLA) region [DQA1*0501-DQB1*0201 (DQ2) and DQA1*0301-DQB1*0302 (DQ8)]. This locus harbours several human endogenous retroviral (HERV) long-terminal repeats (LTR). LTRs within the HLA region have been shown to confer additional susceptibility to type 1 diabetes and rheumatoid arthritis. DESIGN: We investigated the role of LTR3 and LTR13, both of which are located adjacent to the DQB1 gene, in Addison's disease. PATIENTS: Eighty-seven patients and 160 controls were genotyped for HLA-DQA, -DQB, and the presence or absence of LTR3 and LTR13. RESULTS: Significantly more patients' HLA alleles than those of controls carried the LTR13 insertion (19.0% vs. 10.6%, P = 0.0143), whereas there was only a trend for LTR3 (allele-wise chi-squared test: P = 0.0941). Both, LTR3 and LTR13 are in strong linkage disequilibrium with DQ8, which itself was significantly more frequent in patients than in controls (29.9% vs. 15.0%, P = 0.0089). However, significantly more alleles of DQ8+ patients than of DQ8+ controls carried the LTR13 insertion (44.2% vs. 18.8%, P = 0.0119), whereas we did not observe any difference for LTR3 in the DQ8+ subset (30.5 vs. 23.1%, P = 0.9416). CONCLUSIONS: We have found preliminary evidence that the endogenous retroviral element DQ-LTR13, but not LTR3, is associated with Addison's disease. LTR13 appears to enhance HLA-DQ8 mediated disease risk. This retroviral insertion therefore might represent a novel susceptibility factor in Addison's disease, but these findings need to be confirmed in a larger data set.

Addison Disease↗
PubMedDate not supplied

No evidence of association of CTLA4 polymorphisms with Addison's disease.

BACKGROUND: Addison's disease (AD) is an autoimmune disorder caused by the destruction of the adrenal gland by the lymphocytes in genetically susceptible individuals. The contribution of HLA genes to the genetic risk to AD has been known for a long time; however, non-HLA genetic factors are likely to be required for the development of the disease. Several studies have associated the CD28/CTLA4 region on chromosome 2q33 with the disease in different populations. The cytotoxic T lymphocyte-associated antigen 4 (CTLA4) gene encodes a receptor involved in the control of T cell proliferation and mediates T cell apoptosis. AIM: To determine the contribution of two polymorphisms of the CTLA4 to the disease; the A/G dimorphism at position +49 in exon 1 and the (AT)n microsatellite in the 3' untranslated region of exon 3. PATIENTS: Fifty seven patients with autoimmune AD (autoimmunity for anti 21-hydroxylase was confirmed) and 111 unrelated healthy subjects from the general populations were analyzed as controls. METHODS: Restriction enzyme digestion of polymerase chain reaction (PCR) amplified genomic DNA for the A/G dimorphism and PCR followed by high-resolution electrophoresis for the (AT)n microsatellite. For disease association studies, the case-control approach was used. RESULTS: The frequency of the A allele of 49 A/G polymorphism was 65.79% in the patients compared with 72.07% in the control group. These differences were not significant. Analysis of the (AT)n polymorphism identified 19 different alleles, ranging from 262 to 308 bp in length, but no allele was significantly associated with the disease. CONCLUSIONS: Our results did not show any evidence of association of any of the CTLA4 gene polymorphisms with the disease. This might result from population-specific differences in genetic and environmental susceptibility to AD.

Addison Disease↗
PubMed1997

Autoimmune endocrine disease.

Autoimmune endocrine diseases are serious disorders that utilize immense health care resources and cause tremendous disability. They include type 1 diabetes mellitus, thyroiditis, Graves disease, Addison disease, and polyglandular syndromes. Analysis of the basis of autoimmune diseases has been aided by the application of new knowledge in immunologic physiology. Recent investigations using these techniques have revealed complicated disorders that have varied pathogenesis and complex genetic predispositions. While the mainstay of treatment for these diverse diseases remains the replacement of hormones produced by the damaged endocrine organ, investigations into the pathogenesis of these disorders provide hope for the development of specific therapeutic measures to block their pathologic basis.

Addison Disease↗
PubMed2006

Prevalence of coeliac disease in Italian patients affected by Addison's disease.

OBJECTIVE: It is well known that coeliac disease is associated with autoimmune endocrine diseases, such as autoimmune thyroid disease and insulin-dependent diabetes mellitus. Recently, coeliac disease has been shown in approximately 10% of patients with autoimmune Addison's disease. Addison's disease is the most common cause of primary adrenocortical insufficiency and it shares several clinical features with coeliac disease. Although hyperpigmentation and hypotension are the most specific signs, gastrointestinal symptoms are common and can be the first complaints of the patients. The aim of our study was to investigate the prevalence of coeliac disease in Italian patients with Addison's disease. MATERIAL AND METHODS: Seventeen consecutive patients affected by Addison's disease (14 F, mean age 53.9 years, range 26-79 years) were enrolled in the study. Eleven of them were affected by Addison's disease associated with autoimmune thyroid disease and/or insulin-dependent diabetes mellitus; the other 6 patients were suffering from isolated Addison's disease. Diagnosis had been performed at the age of 40.5 years (range 23-55). Steroid treatment had already been started in 16 of the patients. Endomysial antibodies were tested in all of them and a duodenal biopsy was taken in those found to be positive for antiendomysial antibody (EMA). RESULTS: One out of 17 patients was found to be EMA positive. Duodenal biopsy confirmed the diagnosis of coeliac disease by showing subtotal villous atrophy. CONCLUSIONS: Although we studied only a small sample, our preliminary results confirmed that Addison's disease is associated with coeliac disease, being present in 5.9% of patients with Addison's disease. Since the symptoms can be similar and treatment of Addison's disease can mask coeliac disease, this association should always be actively investigated.

Addison Disease↗