Multiple Autoimmune Endocrinopathy Including Pituitary Adrenocorticotropic Hormone Cells?

To the Editor.  —I read the article by Mazzone et al¹ with much interest, because, for some five years I treated a 48-year-old man with proved pernicious anemia, primary hypothyroidism, and an isolated deficiency of adrenocorticotropic hormone (ACTH). Antibodies against parietal cells and thyroid microsomes were strongly positive. A preliminary investigation of his serum samples by Pouplard et al² at Middlesex Hospital, London, was positive for antibodies against pituitary cells. This case will be published within a few months, when more specific tests for ACTH producing—cell antibodies have been accomplished.To my knowledge, this will be the first reported case of a patient with clinical and laboratory symptoms of multiple autoimmune endocrinopathy. Five years following diagnosis, the patient is well and continuing triple substitution therapy.