Multiple Autoimmune Syndrome and Lupus

People with lupus can often have other autoimmune disorders as well. Because the different disorders interact, this makes treatment and management complicated.

Systemic lupus erythematosus (SLE) is known as the “great imitator” because it has so many potential symptoms that it can mimic many other diseases. However, sometimes it is more like ‘a great masker,’ covering up the presence of other diseases. 

Other autoimmune diseases can be present alongside lupus. In fact, nearly 25% of people with autoimmune diseases have more than one present, a condition called polyautoimmunity or “multiple autoimmune syndrome.” While debilitating and difficult to navigate, managing all multiple autoimmune diseases is possible. It is even possible to bring them to remission, where the symptoms are dormant.

Polyautoimmunity and Lupus

Polyautoimmunity, also known as Multiple Autoimmune Syndrome is how medical professionals describe a combination of three or more autoimmune diseases that are present in the same person. For people with SLE, common co-existing autoimmune diseases include autoimmune hypophysis, hidradenitis suppurativa, fibromyalgia, Sjogren’s syndrome and rheumatoid arthritis. However, many other autoimmune conditions can co-occur with lupus, including scleroderma, myasthenia gravis, thyroid disease, dermatitis herpetiformitis, and diabetes. 

Symptoms of Polyautoimmunity and Lupus

Autoimmune diseases share a cause and so may have overlapping symptoms, and some might even be treated with the same methods. However, it should be clarified that are separate and interlocking diseases that can have different root causes. Sometimes treatments don’t overlap, and the treatment for one autoimmune disease could make the symptoms of the other diseases worse. Medical treatment teams for lupus should – and often do – screen for other autoimmune diseases once SLE is diagnosed. 

Many autoimmune diseases have symptoms in common, which can make this complicated, including:

• Rashes and other skin lesions
• Fatigue
• Brain Fog
• Pain
• Kidney Damage
• Anemia 
• Mouth ulcers and tooth issues
• Weakened immune system

Multiple autoimmune diseases can contribute to each of these symptoms, making treatment of all of the disorders necessary.

What Causes Lupus and Autoimmune Disease?

Autoimmune disease is caused by a combination of genetics and environmental stress. The genes involved tend to be differences in immune system activation, cell-to-cell signaling, and how cells proliferate. Whether these changes are overall good or bad is not clear, but they do appear to make certain groups of people more vulnerable to the ‘glitches’ in the immune system that cause autoimmune diseases.

Some people with autoimmune diseases find that a trigger incident like a major illness, injury, or traumatic life event seemed to tip things over the edge for their body and set off the noticeable symptoms of their disease. For others, it’s an accumulation of many events like job stress or exposure to pollutants. Sometimes, however, there is no clear ‘trigger’ or ’cause’ for the autoimmune disease. In either case, stress from mental and physical sources exacerbate the symptoms of autoimmune disease through inflammation.

Inflammation, stress, and autoimmune disease

Autoimmune diseases share a cause – the immune system is constantly set to high alert, a state called inflammation, and mistakenly attacks the body’s own cells.  Stress causes inflammation to increase, and inflammation itself stresses the body, creating a cycle of rising inflammation and autoimmune symptoms.

In addition to all autoimmune diseases being influenced by physical and mental stress levels, they can also share triggers. The stress from the different autoimmune diseases can affect each other, and different autoimmune conditions can go into remission at different times. It can be very complicated to navigate and manage several different conditions at once, with lupus having the added frustration of having such a wide range of symptoms. However, many autoimmune conditions use the same medications and lifestyle changes (including diet) to reduce inflammation, which does simplify treatment somewhat.

Treating Multiple Autoimmune Diseases and Lupus

While most autoimmune diseases are treated with immunomodulatory drugs such as steroids and immunosuppressants, they are different from each other and can respond differently to treatments. One of the reasons that it is important to know what autoimmune conditions a person has is that some therapies used to treat autoimmune conditions, particularly medications, can cause other conditions to become worse or trigger the symptoms. 

Glucorticoids, including prednisone, are used to treat the symptoms of lupus and other autoimmune diseases. They are very powerful medications but come with some severe side effects.

Aside from medications, people with lupus and other autoimmune diseases have several lifestyle changes that will benefit them. Eating a balanced, anti-inflammatory diet, getting regular exercise, regularly cleaning and sanitizing their environment, and reducing stress will reduce their symptoms and improve their health overall. Some people also react poorly to extremes in temperature and the stress of travel, which they are also advised to avoid. 

These lifestyle changes can be difficult but are possible for many people.