The natural history of adrenal function in autoimmune XXXX with adrenal autoantibodies.

@entity1 @entity1369 @entity6 @entity5343 @entity701 @entity916 @entity792 @entity774
@entity774 ( @entity774 ) were found in 23 of 2571 (0.9%) @entity1 with organ-specific @entity792 , in one of 632 first-degree relatives of insulin-dependent @entity6 @entity1 , and in none of 375 normal controls. In @entity774 -positive subjects the prevalence of human leucocyte antigens (HLA)-A1, -B8 and -DR3 was significantly higher with respect to the general population. Two groups were followed (15 subjects persistently positive for @entity774 and 51 negative subjects) for a mean period of 3.2 years. Yearly tests were made for @entity774 and adrenal function. Of the 15 subjects persistently positive for @entity774 , six developed @entity5343 after a period varying from 6 months to 10 years. Of the 51 subjects initially negative, two became positive during follow-up, and one of these developed @entity5343 15 months later. In contrast, all the remaining 49 persistently negative subjects maintained normal adrenal function tests. Overall, of the 17 positive subjects, seven (41%) developed @entity5343 , three (18%) showed various degrees of subclinical adrenocortical failure and the remaining seven maintained normal glandular function. In the positive @entity1 the yearly incidence of detriment in adrenal function was 19%. @entity1 who developed @entity5343 showed significant association with HLA-B8 phenotype. The development from normal adrenocortical function to overt @entity5343 seemed to progress through four distinct stages of functional impairment: increased plasma @entity916 activity with normal/low @entity1369 (stage 1), low @entity701 response after i.v. administration of ACTH (stage 2), increased ACTH (stage 3), and low basal @entity701 (stage 4).(ABSTRACT TRUNCATED AT 250 WORDS)
