Adrenal Antibodies – Referral Test
Gold topped tube
1mL Serum (Gel 5mL Yellow tube)
Positive or Negative
Normal result = Negative
2 weeks (referred to RVI Newcastle)
Interferences: None known
Interpretation: Results are reported as Weak Positive, Positive or Negative for each organ specificity. A test result should not be considered of diagnostic value in itself, but used in conjunction with details of the patient’s clinical symptoms, clinical history and any other available data to produce an overall clinical diagnosis. Absence of antibody does not rule out an autoimmune endocrinopathy.
Indication: Autoimmune Addison’s and polyglandular autoimmune disease.
Background Information: Cytochrome P450 enzymes involved in steroid biosynthesis are the targets of autoimmune attack against steroid producing cells. These include 17 alpha-hydroxylase (P450c17), 21 alpha-hydroxylase (P450c21) and cholesterol desmolase (P450scc) enzyme. Antibodies that stain more than one tissue react with enzymes common to the hormonal synthetic pathways in these tissues and are generally termed “steroid cell antibodies”. Antibodies to these enzymes can be associated with autoimmune Addison’s disease where a gradual destruction of the adrenal gland leads to adrenocortical insufficiency. It is a chronic disorder with a long pre-clinical period and in the majority of cases there are adrenal cortex antibodies present. The presence of these antibodies can predict the risk of progression to adrenal failure. Steroid cell antibodies can also be associated with premature ovarian failure and premature testicular failure. They are also associated with the autoimmune polyglandular syndrome types 1,2 and 3. Autoimmune endocrinopathy may be seronegative in a minority of cases.
References: Kahaly G. Polyglandular autoimmune syndromes. Eur. J. Endocrinol. 2009. 161:11-20. Coco G, et al. Estimated risk for developing autoimmune Addison’s disease in patients with adrenal cortex antibodies. J. Clin. Endocrinol. Metab. 2006. 91:1637-1645. Betterle C, Coco G, Zanchetta R. Adrenal cortex autoantibodies in subjects with normal adrenal function. Best Prcatice and Research Clinical Endocrinology and Metabolism. 2005. 19(1): 85-99. Soderbergh A, et al. Prevalence and Clinical Associations of 10 Defined Autoantibodies in Autoimmune Polyendocrine Syndrome Type I. J.Clin.Endocrinol.Metab. 2004. 89: 557-562. Betterle C, et al. Autoimmune Adrenal Insufficiency and Autoimmune Polyendocrine Syndromes: Autoantibodies, Autoantigens, and Their Applicability in Diagnosis and Disease Prediction. Endocrine Reviews. 2002. 23(3): 327-364.
Phone Gateshead Lab: 0191.4456499 Option 4, Option 1
See Also: Endocrine antibodies.