IMMUNOLOGICAL ASPECTS OF PREMATURE OVARIAN FAILURE ASSOCIATED WITH IDIOPATHIC ADDISON'S DISEASE

Abstract

Antibodies reactive with the theca interna of the ovary, the interstitial cells of the testis, and the adrenal cortex were detected in the sera of 5 of 77 patients with idiopathic adrenal insufficiency. All 5 of these patients had either complete failure of menstruation or an early menopause. 1 of these 5 patients also had antibody reactive with ova and spermatids, and 3 had antibody reactive with placental trophoblasts. Only 1 of the remaining 72 patients with idiopathic Addison's disease was known to have premature failure of menstruation. Antibody reactive with gonadal tissue was absent in 34 patients with tuberculous Addison's disease, 111 control subjects matched with the Addison's patients for age and sex, 43 patients with gonadal dysgenesis that was not associated with Addison's disease, 50 postmenopausal females, and in 251 subjects with pernicious anæmia or thyroid autoimmune disease. Antibody reactive only with the theca interna of human ovary and with adrenal cortex was found in 1 of 24 patients with Cushing's syndrome. Primary gonadal failure may be part of a polyendocrinopathy of which idiopathic Addison's disease is an integral part and which is characterised by the formation of autoantibodies to the respective tissues.