Re: autoimmune adrenalitis

[Guest guest]

I came across this...autoimmune adrenalitis - which is ideopathic 's

Disease (fake addison's?)...and was struck that it strikes women

predominantly...and there is an antibodies test. anyone ever heard of it?

Cindi

AUTOIMMUNE ADRENALITIS — What long was termed " idiopathic " primary adrenal

insufficiency is the result of an autoimmune process that destroys the adrenal

cortex. There is evidence of both humoral and cell-mediated immune mechanisms

directed at the adrenal cortex, often associated with autoimmune destruction of

other endocrine glands. Antibodies that react with several steroidogenic

enzymes (most often CYP21A2 [P450c21 or 21-hydroxylase]) and all three zones of

the adrenal cortex are present in the serum of 60 to 75 percent of patients with

autoimmune primary adrenal insufficiency, but only rarely in patients with

other causes of adrenal insufficiency, in first-degree relatives of patients

with autoimmune primary adrenal insufficiency, or in normal subjects [2,10-13].

(

See " Pathogenesis of autoimmune adrenal insufficiency " ).

Patients with autoimmune adrenal insufficiency as part of one of the

polyglandular autoimmune syndromes are predominately female (70 percent). In

contrast,

patients with isolated autoimmune adrenal insufficiency are predominately

male (71 percent) during the first two decades of life, are equally male and

female in the third decade, and are predominately female (81 percent) thereafter

[

14]. The explanation for these sex differences is unknown.

The first evidence of autoimmune adrenal insufficiency is usually an increase

in plasma renin activity in association with a normal or low serum

aldosterone concentration, suggesting that the zona glomerulosa is involved

initially [

15,16]. Several months to years later, zona fasciculata dysfunction becomes

evident, first by a decreasing serum cortisol response to corticotropin (ACTH)

stimulation, later by increased basal serum ACTH concentrations, and, finally by

decreasing basal serum cortisol concentrations and symptoms [15,17].