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Anti-21-hydroxylase antibodies, HLA class II predicted Addison’s disease
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New observational Norwegian registry data reveal that Addison’s disease is almost exclusively autoimmune, and is associated with high autoimmune comorbidity.
The observational study included a subsample of 664 patients with Addison’s disease registered in nationwide databases.
The prevalence of autoimmune or idiopathic Addison’s disease was 144 per million, and the incidence was 0.44 per 100,000 per year, according to 1993 to 2007 data.
Ten percent reported familial disease, and 66% reported autoimmune comorbidity. Nearly half (47%) reported thyroid disease, 12% reported type 1 diabetes, 11% vitiligo, 10% vitamin B12 deficiency and 6.6% premature ovarian insufficiency.
Most patients were taking 40.5 mg cortisone acetate and 0.1 mg fludrocortisone daily.
Researchers confirmed “the strong association of Addison’s disease to the haplotypes DR3-DQ2 and DR4-DQ8 previously reported in Norwegian patients,” which predicted early onset (OR=32). Anti-21-hydroxylase antibodies were reported in 86% of patients.
Short-Form 36 vitality scores revealed reduced health-related quality of life, especially for patients with diabetes concomitant thyroid autoimmunity was not associated with lower quality of life. The researchers concluded that “treatment modalities to improve health-related quality of life are needed.”
Erichsen MM. J Clin Endocrinol Metab. 2009;doi:10.1210/jc.2009-1368.