Many endocrine disorders are now recognized to be immune mediated. The presence of
autoimmune disease increases an individual's risk for other autoimmune diseases whose
early identification can prevent morbidity and even death. Autoimmunity usually develops
in association with a series of specific human leukocyte antigen (HLA) alleles. In
some disorders, such as celiac disease, an environmental triggering factor has been
identified, but for most autoimmune endocrine disorders, environmental triggering
factors are not identified, but the humoral and cellular arms of the immune system
target self-antigens years before the onset of disease. The majority of endocrine-related
autoantibodies are detected using radioimmunoassay methods, and many assays have been
assessed in international workshops. There are still areas for improving the current
assay methods, especially in sensitivity, specificity, and reproducibility. The challenges
in improving autoantibody detection include defining assay characteristics that improve
specificity (eg, recognition of multiple epitopes) while maintaining sensitivity.
Ultimately, it will be beneficial to move away from using radioactive material. In
this article, we review autoantibodies related to various endocrine and related disorders.
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