The autoimmune tautology with a focus on systemic sclerosis

In the current issue of IMAJ, Rossi et al. [1] report a unique case of multiple autoimmune syndrome (MAS) characterized by the coexistence of systemic sclerosis (SSc), autoimmune liver involvement, antiphospholipid syndrome (APS) and Hashimoto’s thyroiditis. MAS, first described in 1988 by two French physicians, Humbert and Dupond [2], is the best example of polyautoimmunity, the presence of more than a well-defined autoimmune disease (AD) in a single patient [3]. To define a patient with MAS, at least three ADs should coexist [2,3].