Anti-adrenal cellular hypersensitivity in Addison's disease. II. Correlation with clinical and serological findings.

Previous observations suggesting the existence in idiopathic Addison's disease of a state of anti-adrenal cellular hypersensitivity is extended to a larger material comprising thirty cases of idiopathic Addison's disease and seven cases of tuberculous Addison's disease. The specific anti-adrenal humoral and cellular hypersensitivity is evaluated by means of the indirect immunofluorescence technique and the leucocyte migration test, respectively. Anti-adrenal cellular hypersensitivity was demonstrable in 46% of patients with idiopathic Addison's disease but in no case of Addison's disease of unquestionable tuberculous origin. Anti-adrenal cellular hypersensitivity could be demonstrated more frequently in males (eight out of eleven) than in females (six out of nineteen). Anti-adrenal humoral hypersensitivity, i.e. occurrence of circulating anti-adrenal antibody, could be demonstrated in 73% of the patients with idiopathic Addison's disease. Humoral and/or cellular anti-adrenal hypersensitivity was found in 90% of the patients with idiopathic Addison's disease. No correlation was observed between the occurrence of anti-adrenal cellular hypersensitivity, and the duration of clinical illness and the presence or absence of anti-adrenal antibody. In two patients with diabetes mellitus humoral as well as cellular anti-adrenal hypersensitivity was demonstrated, although they had no clinical signs of Addison's disease.