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Clin Exp Immunol. 2019 Mar;195(3):364-368. doi: 10.1111/cei.13231. Epub 2018 Nov 14.

21-hydroxylase autoantibodies are more prevalent in Turner syndrome but without an association to the autoimmune polyendocrine syndrome type I.

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Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark.
Department of Molecular Medicine, Aarhus University Hospital, Denmark.
Department of Pediatrics, North Sealand Hospital, Hillerød, Denmark.
Department of Clinical Science, University of Bergen, Norway.
K.G. Jebsen Center for Autoimmune Disorders, University of Bergen, Norway.
Department of Medicine, Haukeland University Hospital, Bergen, Norway.


Turner syndrome (TS) is associated with an increased frequency of autoimmunity. Frequently observed autoimmune diseases in TS are also seen in the autoimmune polyendocrine syndrome type I (APS I), of which Addison disease is a key component. An overlapping antibody profile between TS and APS I could be considered. The aim of this work was to study women with TS regarding 21-hydroxylase (21-OH) antibodies and interferon omega (IFN-ω) antibodies, a highly specific marker for APS I, to determine if there are immunological overlaps between TS and APS I. Blood samples from 141 TS were assayed for 21-OH antibodies and IFN-ω antibodies using in-vitro-transcribed and translated autoantigen. Indices with a cut-off point of 57 and 200 for 21-OH antibody and IFN-ω antibody were used as reference. The median age of TS was 31·6 years (range = 11·2-62·2). Positive indices of 21-OH antibodies were present in six TS (4%), with a mean of 144·8 (range = 60-535). None had apparent adrenal insufficiency. There was no age difference comparing 21-OH antibody-positive TS (median age = 33·9 years, range = 17·7-44·7) and 21-OH antibody-negative TS (median age = 31·6 years, range = 11·2-62·2) (P = 0·8). No TS was positive for IFN-ω antibodies (mean = 42·4, range = -435-191). No overlapping autoimmune profile between TS and APS I was found. Autoimmunity against 21-OH among TS patients was more prevalent than previously identified, suggesting an increased risk of adrenal failure in TS. However, whether adrenal impairment will develop remains unknown.


Turner syndrome; adrenal insufficiency; autoimmune polyendocrine syndrome type

[Available on 2020-03-01]

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