Tissue-specific antibodies have been found in the sera of patients with pernicious anemia, chronic lymphocytic thyroiditis, idiopathic adrenal insufficiency, and other endocrine disorders. The role of these autoantibodies in the pathophysiology of such diseases is still uncertain, but the reversal of the histopathological and functional lesions after corticosteroid treatment reported in some patients with pernicious anemia1,2 and chronic thyroiditis3 suggests that altered immunological mechanisms may be important in the development of these conditions. In addition, the familial occurrence of many of these diseases and the presence of more than one disorder in some patients suggests that a genetically determined predisposition to develop autoimmune reactions of this type may exist in some individuals. This report describes antibody studies carried out on a patient with chronic lymphocytic thyroiditis, idiopathic adrenal insufficiency, pernicious anemia, and vitiligo.
This 36-year-old white man was first hospitalized at the age of 23 years