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The previously reported high prevalence of smooth muscle antibodies in neuroblastoma has been found to be associated with a similarly elevated prevalence of anti-cytoskeleton antibodies. The most relevant finding is related to anti-microfilaments (anti-actin) and anti-microtubules antibodies, which were detected with highly significantly different prevalences when compared with a disease control group (p < 0.001 and p < 0.000001, respectively). The correspondence between smooth muscle antibodies and anti-cytoskeleton antibodies is incomplete, and it is more relevant for anti-microfilaments. It is concluded that antigen specificities of smooth muscle antibodies in neuroblastoma are as complex as documented in other diseases. Possible pathogenetic and clinical implications emerging from these data are discussed.

Chronic graft-versus-host disease can mimic various autoimmune disorders, although autoantibodies are rarely detected in the sera of affected patients. Antibodies to cytoskeleton are a frequent finding in patients affected by autoimmune disorders. In all the sera of 16 patients who were submitted to allogeneic bone marrow transplantation, we have found antibodies against cytoskeletal intermediate filaments. Moreover, the titer of such antibodies is quite elevated when compared with those reported in autoimmune disorders. A statistically significant difference between the titers found in patients without and with cGVHD (median 1:40 vs. 1:256, P<0.05) has been found. This would suggest that such antibodies might be relevant in monitoring clinical course. Furthermore, since certain cytoskeleton antigens have been shown to be expressed also on cell membrane, antibodies against intermediate filaments might also play a more important role by interfering with such surface structures.

TO THE EDITOR.— Alopecia areata (AA) is a common dermatologic disease, the origin of which is still unknown.1 A number of studies support the hypothesis that at least a subset of alopecia areata may be immunologically mediated. It has, in fact, been associated with some autoimmune diseases and a variable prevalence of both organ- and nonorgan-specific autoantibodies has been detected in this condition.2-4 As far as antihuman parietal cell antibody (HPCA) is concerned, prevalences reported vary from 4% to 6%5,6 to 19%.7 To our knowledge, the titers and the correlation of this antibody with the actual occurrence of autoimmune atrophic gastritis (AG) in alopecia have never been accurately evaluated.On the basis of a previous study performed in a series of unselected patients with vitiligo,8 we have now evaluated patients with alopecia areata to verify the actual association of autoimmune AG with this condition. For