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Klinische Wochenschrift

, Volume 47, Issue 7, pp 337–343 | Cite as

Autoimmunophänomene bei Erkrankungen endokriner Drüsen

  • Konrad Federlin
Übersichten

Zusammenfassung

Überblickt man die mit verschiedenen immunologischen Methoden erhobenen Befunde bei der Unterfunktion endokriner Drüsen, so zeigt sich, daß kein einheitliches Bild vorliegt. Die vonWitebsky zur Anerkennung eines Autoaggressionsmechanismus geforderten strengen Kriterien können lediglich bei der Immunthyreoiditis als erfüllt gelten. Bei der Unterfunktion der Nebenniere sind die für einen Autoimmunvorgang sprechenden Befunde in der menschlichen Pathologie noch lückenhaft. Hier haben aber die tierexperimentellen Ergebnisse wesentliche Fortschritte gebracht. Die Wahrscheinlichkeit, daß die Mehrzahl der Addison-Patienten an einem Autoimmunprozeß leidet, ist jedenfalls gestiegen. Weit weniger gesichert sind nach wie vor Autoimmunprozesse bei der Entstehung des Diabetes mellitus. Auch hier hat aber das Tierexperiment für die Erklärung der Insulitis bei jugendlichen Diabetikern neue Aspekte ergeben. Dagegen erlauben die nur spärlichen serologischen und morphologischen Befunde bei der Unterfunktion von Hypophyse, Ovar, Hoden und Nebenschilddrüse noch keinerlei Rückschlüsse auf Autoaggressionsmechanismen dieser Drüsen bei Mensch oder Tier. — Der Nachweis von Autoantikörpern, die mit dem Gewebe verschiedener endokriner Drüsen gleichzeitig reagieren, hat zwar gegenwärtig noch wenig klinische, jedoch größere wissenschaftliche Bedeutung, da er auf noch weitgehend unbekannte gemeinsame Antigeneigenschaften dieser Organe hinweist.

Summary

A survey of the present results of endocrine hypofunction, with different immunologic methods indicates that no uniform pattern exists. The criteria ofWitebsky which are postulated for the recognition of an autoimmune mechanism as the cause of lesions in organs, are fullfilled only in thyroiditis. Evidence for autoimmune factors resulting in hypofunction of the adrenals in man is weak. In this regard however, experimental work has yielded essential progress. Thus the probability is increased that patients with Addison's disease are suffering from an autoimmune process. Much less probable is autoimmune involvement in the development of diabetes mellitus. Nevertheless experiments in animals have yielded new aspects in the problem of insulitis in juvenile diabetics.

The rare serological and morphological observations obtained in patients with hypofunction of the hypophysis, ovarian and parathytoid glands do not permit any conclusions regarding autoimmune mechanisms as the cause of disease. The demonstration of autoantibodies reacting with the tissue of different endocrine glands has more importance in scientific meaning than in the clinical sense — at the present time. Apparently these are (rather) unknown antigenic relationships between these organs.

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Copyright information

© Springer-Verlag 1969

Authors and Affiliations

  • Konrad Federlin
    • 1
  1. 1.Abteilung für Endokrinologie und Stoffwechsel des Zentrums für Innere Medizin der Universität UlmGermany

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