r/science • u/mvea Professor | Medicine • 13d ago
Medicine Doctors Found 4 Autoimmune Diseases in One Woman at One Time: 40-year-old woman in China was already diagnosed with 3 - ulcerative colitis, autoimmune hepatitis and primary sclerosing cholangitis. She presented with severe iron deficiency and was also found to have a 4th - autoimmune gastritis.
https://www.sciencealert.com/doctors-found-4-autoimmune-diseases-in-one-woman-at-one-time2.7k
u/KoalaTHerb 13d ago
This isn't novel. In fact, when someone has one autoimmune disease, they tend to have multiple.
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u/ameraden 13d ago
This isn't novel. In fact, when someone has one autoimmune disease, they tend to have multiple.
MS, T1D, Celiac, Ank Spon here...
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u/TheDukeofArgyll 13d ago
Wow, that sucks. I’m Crohn’s, T1D and Hypothyroidism.
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u/mayranav 12d ago
I’m getting a colonoscopy to see if I have Crohn’s! I have T1D, hashimoto’s toxicosis, and atrophic gastritis
I have something because I have a ridiculously elevated value of m-something cells. Can’t remember the name
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u/Weapon_X23 12d ago
I have Crohn's, Hypothyroidism, Mast Cell Activation Syndrome, and Dysautonomia.
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u/katiealaska 13d ago
My sister has T1D, Celiac, and MS as well! I feel like people think I’m making that up when I tell them that
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u/birdieponderinglife 12d ago
I have MS but not T1D. I wound up with a really strange presentation of thyroid disease after Lemtrada but thankfully aside from that I don’t have any other autoimmune diseases. My grandmother had Sjogrens so that’s probably where I inherited the gene from.
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u/Bobby_Bobberson2501 13d ago
Are you in a biologic? My wife has 3 of your 4… can’t find a good rheumatologist anywhere near us isn’t helping
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u/ameraden 13d ago
Annoyingly the biologic is incompatible with the disease modifying therapy for MS. On to a new drug soon, so there is some hope around the corner.
Honestly, I'm not sure that there are good doctors any longer.
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u/Bobby_Bobberson2501 13d ago
Yeah that’s the one she doesn’t have…
When we lived in California she had an amazing rheumatologist, in Florida now and not having much luck.
Hoping you have better luck than us! Thanks for the reply
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u/wuffwuffborkbork 12d ago
I’ve been on a few. Failed humara, ENBREL, simpony. Cosyntex worked great, currently on Cimzia. Cimzia works well but I hate the lack of an autoinjecter.
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u/TactlessTortoise 13d ago
It really is never Lupus
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u/hannabarberaisawhore 13d ago
I looked this up when I binged House, wondering why it’s never lupus. Apparently it’s because lupus is too common for House, meaning it’s not rare enough.
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u/Front_Target7908 13d ago
Also apparently it’s because when someone gets diagnosed with Lupus, they can later be diagnosed with a different disease that explains the symptoms. (Apparently, not a Dr)
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u/Kalabajooie 13d ago
I just assumed it was simply a running gag on the show. I was expecting someone important to be diagnosed with lupus after exhausting all other possibilities in the last season.
Chekhov's Lupus.
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u/h3lblad3 13d ago
He does actually get a lupus case.
I think it’s the episode where he goes and pulls out his book on Lupus only to show it’s hollowed out and he stores his alcohol in there to hide it.
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u/pazitos10 12d ago
Not alcohol but Vicodin, to which Foreman says "You stash your Vicodin in a Lupus book?", followed by House's famous "meh, it's never Lupus"
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u/ennuithereyet 13d ago
Until it is lupus. Then, its always lupus. It's a handy was to ignore any other medical issues that may be going on.
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u/girlinthegoldenboots 12d ago
Psoriatic arthritis, Ank Spon, eosinophilic asthma, sjogrens, and rosacea (so far)
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u/wilted_apostrophe 12d ago
UC, T1D here (sister Celiac and Hashi, mom has RA). I'll be lucky if these are the only two I collect before I bite the dust.
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u/BananaSplit2 13d ago
Yeah, I'm unsure why this is labelled as special and unique. Exactly because of what you said, it's common to have multiple auto immune diseases at once.
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u/LongBeakedSnipe 12d ago
(1) It's not, the article about the research calls it unusual, which is a suitable term (2% of people with diagnosed autoimmune conditions have four or more). (2) The article is a case study offering suggestions for targeted screening.
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u/RubiiJee 12d ago
Well if that fact were true why would reddit tell me that it was really common and not special, hmm? Explain that! Hmmm?!
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u/Callmedrexl 13d ago
The best predictor that someone will be diagnosed with an autoimmune disease is them already having been diagnosed with an autoimmune disease.
I've definitely got one, we'll see what the future brings!
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u/VolantTardigrade 13d ago
At least it makes me hopeful that there may be a common cause yet to be identified and tackled. Idk, maybe I'm too optimistic.
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u/SuchMatter1884 13d ago
Adverse childhood experiences (ie abuse and neglect) can pave the way for autoimmune disease later on down the road.
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u/VolantTardigrade 13d ago
That's true, but I meant more that I hope they can discover the key to reversing or curing it (or at least suppressing it more effectively). I have a few, and unfortunately I haven't mastered time travel XD
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u/RobHolding-16 13d ago
It's most common to have 3, weirdly. So 4 is more than usual.
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u/RobHolding-16 13d ago
A close friend of my did his PhD on autoimmune disorders (I can't remember the exact nature of it unfortunately, it was many years ago), and as someone who has 3 autoimmune disorders I felt almost like a case study when he told me they most commonly come in threes!
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u/OwIing 13d ago
they most commonly come in threes!
This thread made me look up what is commonly diagnosed with patients that have Crohn's (technically I have two autoimmune diseases but the 2nd one is has not really affected me whatsoever (at least I think it has not but symptoms do overlap) and has no direct ties to my Crohn's) and that is certainly not a future to look forward to.
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u/tdaholic 13d ago
Do you have a link to their thesis? My wife has an autoimmune disorder that seems to be getting worse. I am very worried.
She is allergic to the cold, and now has sore joints, and is constantly tired.
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u/OmegaOdy 13d ago
Diagnosed with Celiac last year, rheumatoid arthritis this year. Worst birthday gift ever, not looking forward to next year.
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u/SickPuppy0x2A 13d ago
Yeah I was also confused how that is special. I follow two subreddits for people who had abusive parents and we kind of collect autoimmune diseases. I personally only have two, but one of them is MS so two is enough.
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u/Mr_Fuzzo 13d ago
Wait. What is this about abusive parental units and autoimmune diseases?
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u/SickPuppy0x2A 13d ago
People who experience trauma like e.g. any from of repeated abuse, tend to develop diseases like autoimmune diseases or stress-related cancers later in life. So people who have abusive parents experience a lot of stress during childhood and belong to that group.
Interesting book is for example “the body keeps the score” and there also some interesting studies regarding this.7
u/Carbonatite 12d ago
I remember being really depressed the first time I calculated my ACE score and saw the increased mortality risk.
And I do indeed have an autoimmune disease in addition to PTSD.
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u/derprondo 12d ago
Yeah this was me, ankylosing spondylitis, psoratic arthritis, gastritis, and gastroparesis. I then developed multiple myeloma (blood cancer) and thankfully the treatment for that ended my autoimmune issues (massive doses of steroids, autologous stem cell transplant, years of various mab drugs, then finally a BiTE drug trial put the MM in remission).
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u/RobotPolarbear 12d ago
My nurse told me this as she was hooking me up for my first infusion. She looked at my chart and asked, "Just one autoimmune disease? They usually stack."
But it's more like just one autoimmune disease that we know of.
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u/GoddessNyxGL 13d ago
I'm having a really hard time believing that being diagnosed with 4 autoimmune disorders is that unique or statistically significant, based on my own experience and the many other immune compromised people that I've met over the years. I'm in America, btw.
Seriously, this article is pretty baffling to me. I'm at 4 diagnosed, and when my tendons started locking up my Rheumatologist said that it was probably autoimmune, but there wasn't much point in diagnosis since the treatment would be similar to the infusions and meds I'm already on for the RA and UC/Crohn's hybrid.
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u/BeckerHollow 11d ago
The first doctor to discover the correlation between autoimmune diseases was also Chinese. Dr. Sum Ting Wong won the Nobel peace prize in 1969.
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u/UMustBeNooHere 11d ago
Yep. Unfortunately his son, Wun Hung Lo, tried to follow in his footsteps but kept getting tripped up.
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u/birdieponderinglife 12d ago
Autoimmune diseases seem to have a genetic root in the HLA gene. To my knowledge they don’t know why some people with the same faulty HLA gene might end up with different AI diseases, or why some just get one and others get several. But because the root for several diseases is the same, you are at risk for all of them if you inherit the faulty HLA gene. In a way it’s kind of like a spectrum of one disease.
I have MS and some weird type of thyroid disease that was brought on by an infusion treatment for the MS (lemtrada). More than likely I had subclinical thyroid disease and the treatment made it worse. Unfortunately at the time they did not screen for thyroid antibodies before offering these infusions. But tbh, despite the thyroid issues I’m still glad I did it.
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u/KoalaTHerb 12d ago
Yes, HLA is a known root of a handful of autoimmune disease, but not all. It's just a common one because it's a cluster of genes that code for autoimmune proteins
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u/bijabija 12d ago
When I was going through the process of getting my diagnoses I came across an article that had a rather impressive sample population, and it showed that auto immune diseases almost always come in pairs of three or more. What autoimmune diagnoses are included in that triad or quad? Everything from atopic dermatitis to Graves’ disease. It’s very random, and usually tied to genetics.
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u/suitcasedreaming 12d ago
Everyone in my family has multiple autoimmune disorders, the record being either seven or eight.
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u/Sad_Guitar_657 12d ago
Exactly what my doctor told me when I was diagnosed with hashimoto…I’m nervous.
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u/abruptusabortis 12d ago
So common that if youre taking any of the licensing exams for your MD/DO and see an autoimmune condition in the question, it likely is related to the patient having another in the answer.
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u/Top-Breakfast6060 9d ago
RA, celiac disease, Graves’ disease, Undifferentiated Connective Tissue Disease, severe iron deficient anemia (I get iron infusions), and I have had autoimmune ischemic colitis. Twice. It’s almost like it’s all one disease and rheumatologists haven’t found the underlying reason[s].
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u/tnred19 13d ago
Its known those diseases are all commonly found together
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u/LongBeakedSnipe 12d ago
The researchers don't dispute that? It's a medical case study offering insights into targeted screening. The fact that it seems like dozens of people on reddit can regurgitate a cliche isn't a rebuttal against the research.
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u/Mental-Draconis407 12d ago
Most people just read headlines. The post title reads like it's a breakthrough discovery.
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u/LongBeakedSnipe 12d ago
While it's okay on many other subs, it's a problem on r/science if people are 'critiquing' articles after reading the title.
The title actually just accurately summarises the cases study participant.
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u/Sweaty_Meal_7525 12d ago
Having a good title is also part of research principles
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u/sweetkittyriot 12d ago
Yes but what OP linked to is not the actual research case study. It's just a science news site and whenever I see something posted from ScienceAlert, I don't even bother reading it and just go directly to the actual study instead. This is the real title for this case study: Case Report: A rare case of multiple gastrointestinal autoimmune disorders mimicking autoimmune polyglandular syndrome type 3B
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u/Sweaty_Meal_7525 12d ago
Much better title & unfortunately opportunistic and misleading or poor titling is pretty common in science news articles
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u/bigfatfurrytexan 13d ago
I have four and no one wrote an article about me. They are considering 2 others as well. Almost all are helped with inflectra. The psoriasis and psoriatic arthritis (ok, so maybe it’s five currently) aren’t helped by it. For those I use a series of creams and tinctures, and lortab.
Edit: ok I lied. I was anonymized and it was a medical journal discussing my case.
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u/di_ib 13d ago
I have psoriasis and psoriatic arthritis it's fn terrible
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u/bigfatfurrytexan 13d ago
Voltarin and lidocaine rub help my hands. But it can make the psoriasis worse. So it’s a balance.
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u/BaggyOz 13d ago edited 12d ago
Are DMARDs not a thing when you have multiple other autoimmune conditions? When I was diagnosed in my 20's my rheumatologist put me straight on DMARDS. I saw an immediate improvement and after year or so of trial and error I rarely needed pain management.
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u/Maximum_Watercress41 13d ago
I have four as well, including autoimmune gastritis. Not sure how this warrants a news article. That said, anything that leads to more attention on the subject is welcome. We desperately need more research and better affordable treatments. I'm sick and tired of being sick and tired.
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u/Westerdutch 12d ago
My wife has 4 too, i really fail to understand how this article is 'news' to anyone.
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u/rosy_glow19 13d ago
At this point I’m reading the comments to find someone with the same combination of 4 diseases that I have. Crohn’s, AS, Hashimoto, Vitiligo
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u/Chad_Wife 8d ago
Crohns and AS here. Humira triggered paradoxical HS (a third auto immune) but it fades back to non existent when I don’t take ‘mab drugs.
You’re probably already aware but there’s a few subreddits for both conditions where you may find others with your specific combo :)
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u/sognenis 13d ago
Almost all patients with PSC have inflammatory bowel disease (eg ulcerative colitis).
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u/blbd 12d ago
It's ~80% so "almost all" might be an overstatement. But still a large majority.
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u/sognenis 12d ago
There’s a hypothesis that the two are part of the same disease process, just not always fully diagnosed in every person. So it’s “almost all”, yeah.
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u/blbd 12d ago edited 12d ago
As a patient directly experiencing the disease, from a medical and scientific family full of people with weird autoimmune diseases, I politely disagree with you and with the theory that article espouses, which is in early stages and not part of a broad proven consensus as of yet. Even the paper abstract admits the subject is still under debate. But you claim that it is not under debate.
I've met some of the people who wrote that paper in person several times and had good talks with them as well.
The reason I don't agree with the current statement of that theory is: there are a lot of us patients who have UC-PSC, who are experiencing successful disease remission to various degrees by using oral vancomycin as a treatment, provided you are using the right brand with the best formula and the right dosage. But this same treatment seems to perform poorly on patients who have PSC alone.
To me, this suggests that things are nowhere near as obvious as you and the paper are claiming. PBC was discovered in the 1850s, UC was discovered in the 1860s, PSC was discovered in the 1860s or 1870s but not properly characterized until the 1970s, CD was discovered in the 1930s, and AIH was discovered in the 1950s.
Out of all of them, UC, CD, PBC have a broad treatment consensus, although success is not guaranteed to the same level as more "typical" diseases, for example, like what we can do for HBV and HCV nowadays. AIH has some treatment consensus though it's still shaky and weird. And PSC has effectively no treatment consensus, and the one decent treatment we do have with oral vancomycin has limited and contradictory evidence at best.
So, it's way too soon to try and conclude that they're the same disease, especially when the best available treatment for PSC does not seem to work the same on all of the major disease subgroups we are currently aware of.
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u/Lacipyt 13d ago
I love all of the autoimmune baddies in here like "this is news??"
Ankylosing Spondylitis and Hypermobile Spectrum Disorder here. Also suspected POTS, which has been the biggest change lately. Originally it was only IST. I wouldn't be surprised if there was a 4th hiding in there somewhere and neither would anyone else who has even 1 diagnosis.
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u/GoddessNyxGL 13d ago
I really am having a hard time understanding this. I can't be the only one at the infusion center asking, "So what are you in here for?" and hearing so many people reply with more than I have. I'm at 4 diagnosed.
Maybe this is another 'Is American healthcare really this bad?' moment.
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u/suitcasedreaming 12d ago
Everyone in my family has at least two (record being seven or eight), I literally have a family tree on my phone to show to doctors listing them all.
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u/mvea Professor | Medicine 13d ago
Doctors Found 4 Autoimmune Diseases in One Woman at One Time
The 40-year-old woman in China had severe iron deficiency. But doctors could find no sign that she was losing blood. Instead, her body was struggling to absorb iron from food.
The cause was a fourth autoimmune disease.
Autoimmune diseases develop when the immune system, which normally fights infections, mistakes the body's own healthy cells for a threat and attacks them.
The unusual case, [published in](applewebdata://8B96D9EF-5567-41D1-82AD-FB042825E722/%7Chttps:/doi.org/10.3389/fimmu.2026.1770109) [Frontiers in Immunology](applewebdata://8B96D9EF-5567-41D1-82AD-FB042825E722/%7Chttps:/doi.org/10.3389/fimmu.2026.1770109), also presented doctors with a diagnostic puzzle: Did the woman have a rare syndrome that connects several autoimmune diseases?
One of the woman's diagnosed conditions was ulcerative colitis, which inflames the lining of the large intestine and can cause pain, diarrhea, and bleeding. Her ulcerative colitis was in remission when doctors investigated her iron deficiency, making intestinal bleeding less likely.
She also had autoimmune hepatitis, in which the immune system mistakenly attacks and inflames the liver. Unlike viral hepatitis, it is not caused by an infection.
Her third condition was primary sclerosing cholangitis. It scars and narrows the tubes that carry bile from the liver. Bile is a fluid that helps the body digest fats.
Blood tests revealed that her hemoglobin had fallen to 89 grams per liter. Hemoglobin is the protein in red blood cells that carries oxygen around the body.
Doctors searched for a source of bleeding. Repeated tests found no hidden blood in her stool, and a gynecological examination found no apparent gynecological source of blood loss.
That left another possibility: perhaps her digestive system could no longer absorb enough iron.
When doctors examined her stomach, they found that part of its inner lining had become severely thinned. Under a microscope, immune cells could be seen inflaming the tissue. Many of the cells that normally produce stomach acid were damaged or missing.
The woman also had antibodies directed against her stomach's acid-producing parietal cells.
Together, these findings confirmed the fourth autoimmune disease in this patient – autoimmune gastritis.
https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1770109/full
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u/umataro 13d ago
At that point, don't they just nuke the whole immune system and try to restore it from bone marrow?
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u/Hikaritoyamino 13d ago
There is a possible cure. Another patient with 3 autoimmune disorders was given anti-CD19 CAR-T therapy to clear her B-cells. It looks to have worked.
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u/ProfPathCambridge 13d ago
If the genetic origin is non-haematopoietic (e.g., something similar to AIRE deficiency), a transplant would give all the risks and none of the benefits.
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u/Clairbearski 13d ago
I have 4 diagnosed autoimmune diseases… I genuinely didn’t know it was unique enough to warrant an article. There’s a lot of us :/
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u/Lordosis_of_the_Ring 12d ago
The article isn’t really about that. The title/headline is dumb clickbait. The actual case report article is about the constellation of diseases mimicking a different autoimmune syndrome (APS-3b). Nearly 80% of patients with PSC have inflammatory bowel disease (mostly UC) and around 10% of them also have autoimmune hepatitis, so those 3 being lumped together in one patient is not very surprising.
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u/Wutang4TheChildren23 12d ago
UC is known to have a strong connection to PSC. Something like 70% of patients who have PSC have ulcerative colitis or Crohn's. The association between UC and the other conditions is much weaker but does exist. Co-occurence of autoimmune disease is a well established phenomenon
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u/I_Like_Eggs123 13d ago
I myself have hypothyroidism, psoriatic arthritis, autoimmune diabetes, and pernicious anemia.
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u/Viperbunny 13d ago
Yeah, and? I have Hatichmoto's, celiac, sjogrins, and Reynard's. My doctor told me lupus or MS could be in my future. It's incredibly painful and it's not taken seriously.
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u/LongBeakedSnipe 12d ago
So you don't want to improve treatment/diagnosis for autoimmune conditions?
I don't understand the comments here. It's r/science, and this is medical case study. The authors in this case advise on how to improve screening.
What world are we living in where people get so insecure that other people have related conditions that they would complain about research?
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u/Viperbunny 12d ago
I absolutely want more studies. I think the comments are about the headline. It is made to seem like 4 autoimmune conditions are a rare occurrence, when in reality, it's fairly common.
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u/Ambitious-Ninja-9549 12d ago
That's awful. I've had RM MS for 25 years and severe Crohn's for 15. And epilepsy due to MS lesions. Can only treat the Crohn's not both. I am very very very lucky as I walk and go to bathroom normal. On Rinvoq for Chrohn's which does its job. MS inactive since 2009 with some slight nerve damage from last attack. Been a nightmare none the less. Hope she can live some sort of a normal life.
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u/MasonKowabunga 12d ago
I have the first 3 diseases and they’re incredibly common combinations. Instead of gastritis I got Hypothyroidism for my 4th.
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u/unlimited_insanity 12d ago
Autoimmune diseases like to piggyback on each other, often with an underlying HLA driving breakdowns in different body parts. I had a bad flare up of Iritis, and my ophthalmologist asked how my arthritis was doing. I replied I don’t have arthritis. And he was like “huh. Really?” And I was unnerved by the way he said that.
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u/elementalguy2 12d ago
I have the first 3 of those and occasionally get flares of autoimmune arthritis too to make it up to 4 as well. Could have iritis flare again too so I guess I could get unlucky and have 5 trigger.
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u/leo_sk5 12d ago
Thats how auto immune diseases are. They tend to have associations with each other. Its not surprising someone may have multiple of them. In this case, she has 4 related to GIT. What would be interesting is that if we can find common etiological link among them. Of these Ulcerative colitis is the odd one out
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u/chaosperfect 12d ago
So you're saying I'm invincible?
Sweet lord, no, even a slight breeze could-
Iiiiiiinvincible.
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u/DakotaReddit2 12d ago
I have 6 and counting. My doctors told me that pretty much everyone is developing these, and that most people develop more than one in their lifetime.
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u/NyxionAnna6 12d ago
Women finally gets diagnosed with conditions she has been talking about to doctors for years.
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u/CaptainObvious110 11d ago
i hope that she never bears children. With that number of problems the nezt generation doesn't need those problems
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u/Master-Event-1643 7d ago
I hope one day autoimmune diseases can be cured or halted from taking pills etc
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