{Multiple autoimmune syndrome}
Summary
The combination of at least three autoimmune diseases in the same patient is defined as Multiple Autoimmune Syndrome (MAS) (Cojocaru et. al, 2010).
About 25 percent of patients with autoimmune diseases have a tendency to develop additional autoimmune diseases. MAS is recognized with increasing frequency. Several associations have been proposed as a form of MAS. Multiple autoimmune syndrome can be classified into three groups according to the prevalence of their associations with one another: type 1, type 2 and type 3. Genetic, infectious, immunologic and psychological factors have all been implicated in the development of MAS. In MAS, patients often have at least one dermatological condition, usually vitiligo or alopecia areata. The pathogenesis of multiple autoimmune disorders is not known yet, perhaps environmental triggers and genetic susceptibility are involved. Abnormalities of both humoral and cell-mediated immunity have been described…
type 1 MAS includes myasthenia gravis, thymoma, polymyositis and giant cell myocarditis
type 2 MAS includes Sjögren's syndrome, rheumatoid arthritis (RA), primary biliary cirrhosis (PBC), scleroderma, and autoimmune thyroid disease
type 3 MAS groups together autoimmune thyroid disease, myasthenia gravis and/or thymoma, Sjögren's syndrome, pernicious anemia, idiopathic thrombopenic purpura (ITP), Addison's disease, type 1 diabetes mellitus, vitiligo, autoimmune hemolytic anemia (AIHA), systemic lupus erythematosus (SLE), and dermatitis herpetiformis…
(Cojocaru et. al, 2010)
Symptoms
Difficult to categorize, as they may vary widely.
Diagnostic Criteria
None for autoimmune Rheumatological diseases. (Aggarwal et al, 2015)
For autoimmune disorders with Diagnostic Criteria: meeting the diagnostic criteria of three or more distinct autoimmune diseases.
Study Classification Criteria
Meeting the study classification criteria of three or more distinct autoimmune diseases.
Diagnostic Tests
Potentially helpful tests in the diagnosis of Multiple autoimmune disorder. Caveats include that they may not be clinically useful in a non-research setting, and they may not be widely available.
Autoantibody profile (by autoantigen array chip)
Lymphocytes immunophenotype and cytokine profile (by flow cytometry)
(Rojas et. al, 2021)
Human Leukocyte Antigen (HLA) Associations
Under Investigation
Tissue-Type or Cell-Type Attacked
Under Investigation
Attacking Immune Cell Type or Process
Abnormalities of both humoral and cell-mediated immunity have been described.
(Cojocaru et. al, 2010)
Treatment Modality
Under Investigation
Managing Specialist(s)
Under Investigation
Associated Infections
Cytomegalovirus (Cojocaru et. al, 2010)
Associated Toxins
Under Investigation
Research Authors
M COJOCARU, MD, PhD, Romania
Inimioara Mihaela COJOCARU, MD, PhD, Romania
Isabela SILOSI, MD, PhDc, Romania
Research Institutions
"Titu Maiorescu" University, Romania
"Carol Davila" University of Medicine and Pharmacy, Romania
University of Medicine and Pharmacy, Romania
Average Time from Symptom Onset to Diagnosis
Under Investigation
Last Updated
January 13, 2023
References
Aggarwal, R., Ringold, S., Khanna, D., Neogi, T., Johnson, S.R., Miller, A., Brunner, H.I., Ogawa, R., Felson, D., Ogdie, A., Aletaha, D. and Feldman, B.M. (2015), Distinctions Between Diagnostic and Classification Criteria?. Arthritis Care & Research, 67: 891-897. https://doi.org/10.1002/acr.22583
Cojocaru M, Cojocaru IM, Silosi I. Multiple autoimmune syndrome. Maedica (Bucur). 2010 Apr;5(2):132-4. PMID: 21977137; PMCID: PMC3150011.
Rojas M, Ramírez-Santana C, Acosta-Ampudia Y, Monsalve DM, Rodriguez-Jimenez M, Zapata E, Naranjo-Pulido A, Suárez-Avellaneda A, Ríos-Serna LJ, Prieto C, Zambrano-Romero W, Valero MA, Rodríguez Y, Mantilla RD, Zhu C, Li QZ, Toro-Gutiérrez CE, Tobón GJ, Anaya JM. New insights into the taxonomy of autoimmune diseases based on polyautoimmunity. J Autoimmun. 2022 Jan;126:102780. doi: 10.1016/j.jaut.2021.102780. Epub 2021 Dec 16. PMID: 34923432.