Adrenal insufficiency case study

Of 62 initially autoantibody-negative patients treated with interferon alfa for chronic hepatitis C for a mean of 8 months, three developed antibodies to 21b-hydroxylase, a sensitive assay of adrenocortical autoimmunity (528). However, there were no cases of Addison s disease or subclinical adrenal insufficiency. This study suggested that the adrenal cortex is another potential target organ of autoimmune effects of interferon alfa, along with thyroid and pancreatic islet cells. 

In four cases of Addison s disease which have been studied (163, 164), blood GSH levels ranged from 20 to 76% of the values found in normal man. Since the total blood glutathione (GSH + GSSG) level was unchanged in Addison s disease (163), adrenal insufficiency in man appears to be associated with an abnormality in the oxidation-reduction mechanism. It would be important to determine whether the decreased GSH level is due to a decreased activity of the GSH reductase or to a more rapid rate of oxidation of reduced GSH. 

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