Gonadal autoantibodies in patients with hypogonadism and/or Addison's disease

The sera from 325 normal individuals, 21 patients with Turner's syndrome, 505 patients with insulin-dependent diabetes mellitus, 15 patients with unexplained ovarian insufficiency, and 37 patients with Addison's disease or serological evidence of adrenal autoimmunity were examined for the presence of gonadal autoantibodies by an indirect immunofluorescent technique using sections of human testis. All 12 patients found to have gonadal autoantibodies also had adrenocortical autoantibodies. These autoantibodies were completely absorbed with powdered adrenal cortex and thus were "steroidal cell" antibodies (SCA), cross-reactive with a cytosolic antigen in the steroid-producing cells of adrenal cortex, placental syncytiotrophoblast, Leydig areas of testis, and theca interna/granulosa layer of ovarian follicles. Sera with SCA had reduced titers of adrenal antibodies after repeated absorptions with gonadal or placental tissues, suggesting that adrenal-specific autoantibodies were also present. Sera from patients with only adrenal antibodies had no significant changes in antibody titers after repeated absorptions with gonadal or placental tissues. In conclusion, all gonadal autoantibodies found were SCA. SCA were only found in patients with adrenal autoimmunity, many of whom had hypogonadism. In other patients or in normal individuals, the existence of SCA or gonadal autoimmunity in the absence of adrenocortical autoantibodies must be rare.