Multiple Autoimmune Syndrome Types & Causes

Overview

Multiple autoimmune syndrome occurs when the same patient is diagnosed with at least three different autoimmune conditions, with at least one of them being a skin/dermatological disease such as alopecia or vitiligo.

Around 25 percent of patients known with autoimmune diseases have an increased risk of developing other similar such conditions.

An autoimmune condition is one where the body produces antibodies that attack normal cells, tissue, and organs.

The cause of this process is unknown, but it’s thought that genetic and certain environmental factors, such as being infected with certain viruses, play a role in the development of these conditions.

How is multiple autoimmune syndrome classified?

A classification proposal was constructed for multiple autoimmune syndrome, for patients diagnosed with two different autoimmune conditions, based on which diseases would occur together.

This scheme divides multiple autoimmune syndrome into three different categories. It is a useful tool for identifying a new disease on the onset of new symptoms. It, therefore, helps to determine where the third new condition is likely to fit in.

The classifications are as follows:

  1. Multiple Autoimmune Syndrome Type-1 – Thymoma, myasthenia gravis, giant cell myocarditis, and polymyositis.
  2. Multiple Autoimmune Syndrome Type-2 – Rheumatoid arthritis, Sjogren’s syndrome, scleroderma, biliary cirrhosis, and autoimmune thyroid disease.
  3. Multiple Autoimmune Syndrome Type-3 – Sjogren’s syndrome, autoimmune thyroid disease, pernicious anemia, thymoma and/or myasthenia gravis, type 1 diabetes, Addison’s disease, idiopathic thrombocytopenic purpura, vitiligo, systemic lupus erythematosus, autoimmune hemolytic anemia, and dermatitis herpetiformis.

What causes the syndrome?

Just like the underlying action for the development of autoimmune conditions is not fully understood, so isn’t that of the development of multiple autoimmune syndrome.

It is known though that certain abnormal antibodies are found in certain autoimmune conditions, and numerous organic systems may be affected by these proteins.

Also, since multiple autoimmune conditions can develop in the same individual, or within members of the same family, a genetic mechanism may be involved with the production of abnormal antibodies by the immune system.

In fact, a meta-analysis study published in 2015 revealed that in 10 pediatric autoimmune conditions, 22 gene signals were shared by at least two of the diseases, and 19 shared by three or more. The 10 autoimmune conditions that were involved included systemic lupus erythematosus, type 1 diabetes, celiac disease, ulcerative colitis, Crohn’s colitis, juvenile idiopathic arthritis, autoimmune thyroiditis, psoriasis, common variable immunodeficiency disease, and ankylosing spondylitis.

Another suggested the cause of multiple autoimmune syndrome may include the use of immunomodulating medications for managing certain autoimmune conditions. This is thought to occur due to these drugs causing certain changes to the immune system, which may result in the production of other abnormal antibodies causing different autoimmune conditions.

The Occurrence of Multiple Rheumatological Autoimmune Conditions.

It is actually not uncommon for patients to present with two or more autoimmune conditions. The most common combinations occur with any of the following diseases including rheumatoid arthritis, systemic lupus erythematosus, Sjogren’s syndrome, scleroderma, polymyositis, and vasculitis.

Epidemiology

In the general population, the most commonly occurring autoimmune conditions include autoimmune thyroiditis and rheumatoid arthritis. According to researchers, if a patient is diagnosed with either one the mentioned conditions, then the chances of developing the other one is 1,5 times higher than in someone who doesn’t have any of the diseases. Conversely, regarding the relationship between multiple sclerosis and rheumatoid arthritis, when a patient is diagnosed with one of these conditions, then the risk of developing the other one is actually decreased.

It should also be mentioned that autoimmune conditions are more prevalent in females than in males. This adds further uncertainty over whether the risk of developing a second autoimmune disease or multiple autoimmune syndrome is the same in men and women.

Conclusion

An important point to make note of is that the autoimmune diseases that were found to be the common factors in patients with multiple autoimmune syndrome include systemic lupus erythematosus, autoimmune thyroid disease, and Sjogren’s syndrome.

The suggestion from the medical fraternity is that further clinical studies are conducted into multiple autoimmune syndrome in order to assess the risk of developing the syndrome when looking at gender, as well as to research the causes of the condition in order to better understand the disease and offer appropriate management to affected individuals.

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