Zelissen P M, Bast E J, Croughs R J
Department of Endocrinology, University Hospital, Utrecht, The Netherlands.
J Autoimmun. 1995 Feb;8(1):121-30. doi: 10.1006/jaut.1995.0009.
As the last extensive series of patients with Addison's disease and coincident autoimmune phenomena were published approximately two decades ago, we studied the cause of the disease, the prevalence of autoimmune disorders and the frequency of occurrence of autoantibodies in 91 patients (31 men and 60 women, mean age 45.3-years-old, range 12-77) with Addison's disease. The cause of Addison's disease in six patients was 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 autoimmune Addison's disease at least one other autoimmune disorder was present. Primary hypothyroidism had the highest prevalence (20.5%), followed by vitiligo (9.6%), non-toxic goiter (8.4%), premature menopause (7.3% of the women), Graves' disease (6%), pernicious anaemia (4.8%), Sjögren's disease (2.4%), hypoparathyroidism (1.2%), type 1 diabetes mellitus (1.2%) and coeliac disease (1.2%). The frequency of autoantibodies in the patients with autoimmune Addison's disease was: adrenal antibodies (82.7%), antibodies against microsomal antigens (58%), thyroglobulin antibodies (23.4%), parietal cell antibodies (19.8%), pancreatic islet cell antibodies (6.2%) and ovary antibodies (3.7% of the women). In comparison with other extensive series of patients with Addison's disease, we found the highest prevalence of autoimmune adrenalitis as the cause of Addison's disease, the highest prevalence of hypothyroidism and vitiligo as concomitant autoimmune disorders and the lowest prevalence of type 1 diabetes mellitus.
由于上一批关于艾迪生病及并发自身免疫现象的大规模患者系列研究大约在二十年前发表，我们对91例艾迪生病患者（31名男性和60名女性，平均年龄45.3岁，范围12 - 77岁）的病因、自身免疫性疾病的患病率以及自身抗体的出现频率进行了研究。6例患者（6.6%）艾迪生病的病因是结核病，83例患者（91.2%）被认为病因是自身免疫性肾上腺炎。2例患者（2.2%）艾迪生病由其他病因引起。在自身免疫性艾迪生病患者中，47%至少还存在一种其他自身免疫性疾病。原发性甲状腺功能减退症患病率最高（20.5%），其次是白癜风（9.6%）、非毒性甲状腺肿（8.4%）、过早绝经（女性中的7.3%）、格雷夫斯病（6%）、恶性贫血（4.8%）、干燥综合征（2.4%）、甲状旁腺功能减退症（1.2%）、1型糖尿病（1.2%）和乳糜泻（1.2%）。自身免疫性艾迪生病患者中自身抗体的出现频率为：肾上腺抗体（82.7%）、抗微粒体抗原抗体（58%）、甲状腺球蛋白抗体（23.4%）、壁细胞抗体（19.8%）、胰岛细胞抗体（6.2%）和卵巢抗体（女性中的3.7%）。与其他关于艾迪生病患者的大规模系列研究相比，我们发现自身免疫性肾上腺炎作为艾迪生病病因的患病率最高，甲状腺功能减退症和白癜风作为并发自身免疫性疾病的患病率最高，而1型糖尿病的患病率最低。
