[Multi-organ specific autoimmunity in idiopathic adrenal insufficiency: autosensitization to steroid hormone-producing cells and antigens of the anterior pituitary gland (author's transl)].

Multi-organ specific autosensitization to endocrine active cells, with particular reference to steroid hormone-producing (STH) tissues and cells of the anterior pituitary, has been studied in 23 patients with idiopathic Addison's disease (IAD). Adrenal antibodies were found in 57% of the patients and antibodies reacting with StH-cells (thecal and interstitial cells of the ovarial stroma, placental syncytiotrophoblast and Leydig's interstitial cells) were detected in 22% of cases. A specific staining reaction with antigens of the anterior pituitary was obtained in 2 patients. Dense lymphocytic infiltrates were found in the anterior pituitary, adrenal and thyroid gland in one of the pituitary antibody-positive patients. In addition, dense IgG deposits were observed in some areas of adrenal tissue, which points to in vivo fixation of adrenal antibodies. On the basis of the clinical and immunological heterogeneity observed in patients with adrenal insufficiency a more precise differentiation of Addison's disease is suggested.