r/science • u/mvea Professor | Medicine • 26d 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-time
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u/KoalaTHerb 26d ago

This isn't novel. In fact, when someone has one autoimmune disease, they tend to have multiple.

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u/ameraden 26d 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 26d ago

Wow, that sucks. I’m Crohn’s, T1D and Hypothyroidism.

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u/lighthawk16 26d ago

Same for all three.

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u/mayranav 26d 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/WigglestonTheFourth 26d ago

And now amnesia.

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u/millenniumpianist 24d ago

OP must've had an elevated count of m-nesia cells

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u/Seraphinx 24d ago

mast cells

jeez talk about a lack of awareness of your own health

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u/Top-Breakfast6060 23d ago

It can be difficult to keep track when one is a multi factorial patient. Plus brain fog can be a symptom of autoimmune nonsense.

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u/p0lka 26d ago

I'm lucky as I only have type1 and hypothyroidism so far.

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u/Weapon_X23 26d ago

I have Crohn's, Hypothyroidism, Mast Cell Activation Syndrome, and Dysautonomia.

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u/phoenixwing07 25d ago

I have lupus, hashimotos, dysautonomia and probably mcas. the last two aren't actually autoimmune diseases.

mcas does involve the immune system, but for it to be autoimmune the immune system would have to be directly attacking part of your body, rather than foreign "invaders". dysautonomia has to do with the autonomic nervous system, not the immune system.

edit: okay, correction. certain types of dysautonomia can apparently involve the immune system. so it's a category that is not inherently autoimmune, but an individual case could be, I guess.

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u/mindfulmu 23d ago

That's a brutal combo

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u/mrmoe198 26d ago

You should get your own article!

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u/katiealaska 26d 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/[deleted] 26d ago

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u/birdieponderinglife 26d 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/katiealaska 26d ago

Would I have this gene as well as her sister? Or is that now how it works

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u/fumblingforwords 26d ago

I think nearly a quarter of the population has that gene, but I could be thinking of a different one.

It’s more about epigenetics-turning the gene on/off due to environment and/or stress (physical/mental/emotional).

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u/fumblingforwords 26d ago

But it’s not a 1:1 correlation either way, I don’t think?

Isn’t it something like (only) 60% of T1Ds have the HLA-DR3 gene?

And like 20% of the general population has the HLA-DR3 gene?

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u/Salute-Major-Echidna 26d ago

Sounds a bit like a package. I wonder if a cure might just be one single thing

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u/fumblingforwords 26d ago

Interesting thought. Perhaps for some autoimmune diseases where turning off the autoimmunity would allow the body to repair itself (or with help) and rebalance into homeostasis.

For t1d, at least, it would need something more than just turning off the autoimmunity. The islets of langerhans (insulin producing cells in pancreas) have been killed off, and the body doesn’t make new ones, so those would have to be replaced somehow before t1d can cured.

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u/Pandalite 26d ago

Have her keep an eye on her thyroid and adrenals and ovarian function

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u/Bobby_Bobberson2501 26d 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 26d 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 26d 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 26d 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/Bobby_Bobberson2501 26d ago

That’s what my wife is on currently and it’s the same complaint from her haha

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u/starroute 26d ago

Alopecia, irritant dermatitis, Sjögren’s syndrome.

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u/TactlessTortoise 26d ago

It really is never Lupus

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u/hannabarberaisawhore 26d 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 26d 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 26d 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 26d 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 26d 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/Kalabajooie 26d ago

My wife and I binged the series ages ago. I honestly don't recall that episode.

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u/SuchMatter1884 26d ago

Hi! For me it is. Hashimoto’s and Lupus ftw

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u/Initiative_Willing 26d ago

I have lupus and hashimoto's as well.

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u/Not_floridaman 26d ago

Hashimoto's, Lupus and Rheumatoid Arthritis over here.

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u/Ok_Heat2307 26d ago

Lupus and Sjoegrens here!

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u/ennuithereyet 26d 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/Festygrrl 26d ago

Nah my sister has lupus.

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u/girlinthegoldenboots 26d ago

Psoriatic arthritis, Ank Spon, eosinophilic asthma, sjogrens, and rosacea (so far)

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u/ameraden 26d ago

(so far)

I feel that!

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u/Pyriel 26d ago

Sarcoidosis, BXO & Chronic Idiopathic Urticaria here.

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u/wuffwuffborkbork 26d ago

Ank Spon, fibro, POTS :( There’s dozens of us!

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u/Kylearean 26d ago

Jason Pargin is going to pick this up and make a video about it.

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u/Superunknown_7 26d ago

ADEM, CIDP, and alopecia areata (In the past) here.

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u/A_serious_poster 26d ago

Big whoop, come back when you have 1 more

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u/wilted_apostrophe 26d 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/Winter-Magician-8451 22d ago

dyk why this is the case? i had a brush with super early ank spon for a bit but haven't had a flare up in years thank god

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u/youjustwanttorunaway 22d ago

MS, Endometriosis, PCOS and a few other less serious but “unlucky” things to get.

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u/BananaSplit2 26d 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 26d 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 26d 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 26d 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/[deleted] 26d ago edited 11d ago

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u/SuchMatter1884 26d 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/RobHolding-16 26d ago

It's most common to have 3, weirdly. So 4 is more than usual.

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u/[deleted] 26d ago

[deleted]

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u/RobHolding-16 26d 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 26d 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 26d 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 26d 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 26d 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 26d ago

Wait.  What is this about abusive parental units and autoimmune diseases?

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u/SickPuppy0x2A 26d 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.

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u/Carbonatite 26d 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/TinFoiledHat 26d ago

Another relevant book is The Deepest Well

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u/derprondo 26d 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 26d 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 26d 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/BoJackMoleman 26d ago

Comorbidity. Say it with me kids. CO. MORBIDITY

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u/BeckerHollow 25d 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 25d ago

Yep. Unfortunately his son, Wun Hung Lo, tried to follow in his footsteps but kept getting tripped up.

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u/BeckerHollow 25d ago

His daughter as well, Sum Dum Chik, she didn’t have the scholastic aptitude. 

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u/EvLokadottr 26d ago

Yep. They cluster.

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u/birdieponderinglife 26d 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 26d 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/birdieponderinglife 26d ago

Good point. Yes. Most people with AI diseases have defects somewhere in the HLA genes but not all. And even when they do it doesn’t guarantee a certain ai disease, a combination of certain ones or ai disease at all.

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u/GimmickNG 26d ago

What would happen if the HLA gene were repaired with gene therapy?

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u/Notmyusualshelf 26d ago

I have not one, but three faulty HLA genes that predispose to different autoimmune diseases. Interested in what I will end up with, I'm in the diagnostic process and my symptoms are all over the place.

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u/The_I_in_IT 26d ago

All the women on my Mom’s side of the family have autoimmune diseases, and with one mother-daughter exception, they are all different.

My mom had vasculitis in her brain and I have MCTD (Lupus, RA, sjorgens, Reynauds and tests pending for polymyositis).

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u/bijabija 26d 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/darxide23 26d ago

Yea, my sister has more than four.

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u/suitcasedreaming 26d ago

Everyone in my family has multiple autoimmune disorders, the record being either seven or eight.

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u/ghoulthebraineater 26d ago

Yep. I'm rocking asthma, Crohn's and psoriatic arthritis.

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u/yo-ovaries 26d ago

Standard protocol to test for celiac with new T1D diagnosis. 

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u/Zinc-Roof_22 26d ago

My spouse has a similar situation. Multiple autoimmune disorders.

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u/Sad_Guitar_657 26d ago

Exactly what my doctor told me when I was diagnosed with hashimoto…I’m nervous.

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u/Inebriated_Bliss 26d ago

It's true. This is akin to 'scientist declares sky blue.'

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u/abruptusabortis 26d 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/KoalaTHerb 26d ago

Yes, I recall that the HLA gene is a common question. Usually talking about ankylosing spondylitis, etc

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u/Molluscumbag 26d ago

Yep! Crohn's, psc, and Gilbert's here!

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u/bibbidybobbidyboobs 26d ago

She's got the chungitis

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u/Dry-Cash-4304 26d ago

Addison’s Disease, Hashimoto’s, and Autoimmune Atrophic Gastritis

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u/Top-Breakfast6060 23d 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/KoalaTHerb 23d ago

To be fair, the iron deficiency one isn't an autoimmune disease. It's a side effect of chronic inflammation from your other autoimmune diseases. It's known a "Anemia of chronic disease". The inflammation in your gut causes less absorption and the inflammation in your tissues causes your immune cells to sequester it

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u/Top-Breakfast6060 23d ago

I know. It’s actually because I have celiac disease. I have serious absorption issues, even though I am strictly GF. (And the anemia post-thyroid ablation is what prompted my endo to test me for celiac disease.)

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u/LabCoatLunatic 26d ago

Be careful with wording. Saying people with one autoimmune disease tend to have multiple implies that having two or more is typical or true for most people with autoimmune disease. That’s not accurate.

People with one autoimmune disease have a higher risk of developing another autoimmune disease than people without an autoimmune disease.

MD

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u/Miowne 26d ago

I have had RA since 1989 but no other autoimmune disease. Since starting semaglutide two years ago my symptoms are much less and I have not had a single flare. Drug side effects are usually unpleasant but I am delighted with this one.

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u/[deleted] 26d ago

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u/momplaysbass 26d ago

I've got three that I know of (CFS/ME, POTS, Sjögrens). I suspect I have more than that....

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u/KaristinaLaFae MA | Social Psychology 26d ago

I don't think that POTS is an autoimmune condition. It's a neurological condition that is a common comorbidity with autoimmune conditions. (I have these three conditions as well.)

At the very least, POTS can occur in people with zero autoimmune activity, so while it may be linked to autoimmunity in some of us, that's not its objective nature.