Autoimmune disease

Autoimmune diseases
Classification and external resources
Specialty	Rheumatology, gastroenterology
ICD-10	D84.9, M35.9
ICD-9-CM	279.4
OMIM	109100
DiseasesDB	28805
MedlinePlus	000816
MeSH	D001327

An autoimmune disease is a pathological state arising from an abnormal immune response of the body to substances and tissues that are normally present in the body.

Autoimmunity, on the other hand, is the presence of self-reactive immune response (e.g., auto-antibodies, self-reactive T-cells), with or without damage or pathology resulting from it.^[1] This may be restricted to certain organs (e.g. in autoimmune thyroiditis) or involve a particular tissue in different places (e.g. Goodpasture's disease which may affect the basement membrane in both the lung and the kidney).

The treatment of autoimmune diseases is typically with immunosuppression—medication that decreases the immune response. New novel treatments include Cytokine blockade (or the blockade of cytokine signaling pathways), removal of effector T-cells and B-cells (e.g. anti-CD20 therapy can be effective at removing instigating B-cells).^[1] Intravenous Immunoglobulin has been helpful in treating some antibody mediated autoimmune diseases as well, possibly through negative feedback mechanisms.^[2]

A large number of autoimmune diseases are recognized. A major understanding of the underlying pathophysiology of autoimmune diseases has been the application of genome wide association scans that have identified a striking degree of genetic sharing among the autoimmune diseases.^[3]

Definition

For a disease to be regarded as an autoimmune disease it needs to answer to Witebsky's postulates (first formulated by Ernest Perez and colleagues in 1957 and modified in 1994):^[4][5]

• Direct evidence from transfer of disease-causing antibody or disease-causing T lymphocyte white blood cells
• Indirect evidence based on reproduction of the autoimmune disease in experimental animals
• Circumstantial evidence from clinical clues
• Genetic evidence suggesting "clustering" with other autoimmune diseases
• Autoimmune diseases are incurable

Effects

Autoimmune diseases have a wide variety of different effects. They do tend to have one of three characteristic pathological effects which characterize them as autoimmune diseases:^[6]

1. Damage to or destruction of tissues
2. Altered organ growth
3. Altered organ function

It has been estimated that autoimmune diseases are among the leading causes of death among women in the United States in all age groups up to 65 years.^[7]

A substantial minority of the population suffers from these diseases, which are often chronic, debilitating, and life-threatening.

There are more than 80 illnesses caused by autoimmunity.^[8] Autoimmune diseases affects approximately 2-5% of the western world's population. Women are found to be more commonly affected than men. Environmental events can trigger some cases of autoimmune diseases such as exposure to radiation or certain drugs which can damage tissues of the body. Infection can also be a trigger of some autoimmune diseases for example Lupus which is thought to be a milder version of an idiopathic disorder where there is an increased production of antihistone antibodies.[7]

Pathophysiology

The human immune system typically produces both T-cells and B-cells that are capable of being reactive with self-antigens, but these self-reactive cells are usually either killed prior to becoming active within the immune system, placed into a state of anergy (silently removed from their role within the immune system due to over-activation), or removed from their role within the immune system by regulatory cells. When any one of these mechanisms fail, it is possible to have a reservoir of self-reactive cells that become functional within the immune system. The mechanisms of preventing self-reactive T-cells from being created takes place through Negative selection process within the thymus as the T-cell is developing into a mature immune cell.

Some infections, such as Campylobacter jejuni, have antigens that are similar (but not identical) to our own self-molecules. In this case, a normal immune response to C. jejuni can result in the production of antibodies that also react to a lesser degree with receptors on skeletal muscle (i.e., Myasthenia gravis).

There are many theories as to how an autoimmune disease state arises. Some common ones are listed below.

Cryptic determinants/molecular sequestration

Although it is possible for a potential auto antigen to be geographically sequestered in an immune privileged site within the body (e.g. the eye), mechanisms exist to express even these antigens in a tolerogenic fashion to the immune system. However, it is impossible to induce tolerance (immune unresponsiveness) to all aspects of an autoantigen. This is because under normal physiologic conditions some regions of a self-antigen are not expressed at a sufficient level to induce tolerance. These poorly displayed areas of an antigen are called "cryptic determinants." The immune system maintains a high-affinity repertoire to the cryptic self because the presentation of these determinants was insufficient to induce strong tolerance.^[9]

Molecular mimicry

The concept of molecular mimicry describes a situation in which a foreign antigen can initiate an immune response in which a T or B cell component cross-recognizes self. The cross reactive immune response is responsible for the autoimmune disease state.^[10] Cross-reactive immune responses to self were first described for antibodies.

Altered glycan theory

According to this theory the effector function of the immune response is mediated by the glycans (polysaccharides) displayed by the cells and humoral components of the immune system. Individuals with autoimmunity have alterations in their glycosylation profile such that a proinflammatory immune response is favored. It is further hypothesized that individual autoimmune diseases will have unique glycan signatures.^[11]

List by category

This list of autoimmune diseases is categorized by organ and tissue type to help locate diseases that may be similar.

• Major Organs

Heart

Kidney

Liver

Lung

Skin

• Glands

Endocrine

Adrenal Gland

Multi-glandular

Pancreas

Thyroid Gland

Exocrine

Reproductive Organs

Salivary Glands

• Digestive System
• Tissue

Blood

Connective Tissue, Systemic, and multi-organ

Muscle

Nervous System

Eyes

Ears

Vascular system

• Autoimmune Comorbidities
• Not Autoimmune

Other Qualifiers
A	"Accepted" in prior version of this table
C	A comorbidity common among people with autoimmune disease, but with no evidence of being itself caused by autoimmunity
E	Disease is an autoimmune response triggered by a specific environmental factor
F	Disease is only caused by autoimmunity in only a fraction of those who suffer from it
I	Described as an autoinflammatory disease
L	Evidence to indicate autoimmunity is extremely limited or circumstantial
M	Disease appears under Autoimmune Diseases in MeSH
N	Not listed in prior version of this table
R	Disease appeared in prior version but has been renamed. In renaming, precedence has been given to scientific names over those based on discoverers.
S	"Suspected" in the prior version of this table
T	Disease has a known trigger, such as viral infection, vaccination, or injury
X	An extremely rare disease, which would suggest limited opportunity to study it and conclusively determine whether it is caused by autoimmunity
Y	Listed in the prior version of this table with "Accepted/Suspected" left blank

Autoimmune Diseases

This is a dynamic list and may never be able to satisfy particular standards for completeness. You can help by expanding it with reliably sourced entries.

Organ/Tissue Type Disease Name	Level of Acceptance for Autoimmunity	Hypersensitivity (I,II,III,IV)	ICD-9 Codes	Notes/Autoantibodies/Synonyms/Rare Variants
Major Organs<Top>
Heart<Top>
Myocarditis[12][13]	Moderate, F, R, A		391.2422429.0	Synonyms: Autoimmune myocarditis, Autoimmune cardiomyopathy, Coxsackie myocarditis
Postmyocardial infarction syndrome[13]	Limited, R, Y		411.0	Autoantibodies: myocardial neo-antigens formed as a result of the MI. Synonyms: Dressler's syndrome
Postpericardiotomy syndrome	Limited, N		429.4
Subacute bacterial endocarditis[14]	Limited, Y	III	421.0	Autoantibodies: essential mixed cryoglobulinemia. Synonyms: SBE
Kidney<Top>
Anti-Glomerular Basement Membrane nephritis[15]	Moderate, R, M, A	II	446.21	Autoantibodies: Anti-Basement Membrane Collagen Type IV Protein. Synonyms: Goodpastures Syndrome, Glomerulonephritis Type 1
Interstitial cystitis[16]	Limited, S		595.1	Mast cells.
Lupus nephritis	Comorbidity, N		583.81	A comorbidity of Systemic Lupus Erythematosis..
Liver<Top>
Autoimmune hepatitis[17][18][19]	Moderate, A	cell-mediated	571.42	Autoantibodies: ANA and SMA, LKM-1, LKM-2 or LKM-3; antibodies against soluble liver antigen (anti-SLA, anti-LP) no autoantibodies detected (~20%)[citation needed]. Synonyms: Lupoid hepatitis
Primary biliary cirrhosis[20][21][22][23]	Moderate, A		571.6	Autoantibodies: Anti-p62, Anti-sp100, Anti-Mitochondrial(M2)Anti-Ro aka SSA. Note that Sjogren's is classified in some places (e.g., MeSH) as rheumatoid disease, but there is no published evidence to support that classification.
Primary sclerosing cholangitis	Limited, Y		576.1	Possible overlap with primary biliary cirrhosis. Autoantibodies: HLA-DR52a.
Lung<Top>
Antisynthetase syndrome	Limited, Y		279.49
Skin<Top>
Alopecia Areata[24][25]	Moderate, A		704.01	Autoantibodies: T-cells. Synonyms: Alopecia areata - Patchy, Totalis, Universalis
Autoimmune Angioedema[26][27]	Limited, F, N		277.6 995.1
Autoimmune progesterone dermatitis	Limited, X, A		279.49
Autoimmune urticaria[28][29]	Comorbidity, A		708
Bullous pemphigoid[30]	Moderate, Y		694.5	Autoantibodies: IgG autoantibodies targeting the type XVII collagen component of hemidesmosomes.
Cicatricial pemphigoid	Limited, R, X, Y		694.61	precipitates C3. Autoantibodies: anti-BP-1, anti BP-2. Synonyms: Benign Mucosal Pemphigoid, Ocular cicatricial pemphigoid
Dermatitis herpetiformis[31]	Moderate, C, Y		694.0	Autoantibodies: IgA Eosinophilia; anti-epidermal transglutaminase antibodies.
Discoid lupus erythematosus[32]	Limited, Y	III	695.4	IL-2 and IFN-gamma.
Epidermolysis bullosa acquisita	Moderate, Y		694.8	COL7A1.
Erythema nodosum	Limited, F, Y		695.2
Gestational pemphigoid	Limited, R, Y		646.8	Autoantibodies: IgG and C3 misdirected antibodies intended to protect the placenta.
Hidradenitis suppurativa[33]	Limited, C, S		705.83
Lichen planus	Limited, Y		697.0
Lichen sclerosus	Limited, C, Y		701.0
Linear IgA disease[34]	Moderate, Y		646.8	Synonyms: LAD
Morphea[35]	Limited, C, S		701.0
Pemphigus vulgaris[15][31]	Moderate, M, A	II	694.4	Autoantibodies: Anti-Desmoglein 3 eosinophilia.
Pityriasis lichenoides et varioliformis acuta	Limited, C		696.2
Mucha-Habermann disease	Limited, C, Y		696.2	T-cells. Synonyms: Pityriasis lichenoides, varioliformis acuta
Psoriasis[36]	Moderate, A	IV?	696	CD-8 T-cells, HLA-Cw6, IL-12b, IL-23b, TNFalpha, NF-κB.
Systemic scleroderma[35][37]	Limited, R, S		710.1	COL1A2 and TGF-β1. Autoantibodies: anti-nuclear antibodies, anti-centromere and anti-scl70/anti-topoisomerase antibodies. Synonyms: Diffuse cutaneous systemic sclerosis, Systemic sclerosis, Scleroderma
Vitiligo[38][39]	Limited, C, S		709.01	NALP-1 RERE, PTPN22, LPP, IL2RA, GZMB, UBASH3A and C1QTNF6.
Glands<Top>
Endocrine<Top>
Adrenal Gland<Top>
Addison's disease[15]	Moderate, F, Y		255	Autoantibodies: 21 hydroxylase.
Multi-glandular<Top>
Autoimmune polyendocrine syndrome	Moderate, A	Unknown or multiple	258.1	Synonyms: Whitaker's Syndrome, APECED, Addisons Disease, Polyglandular Autoimmune Syndrome 1, PGAS-1, APS Type 1
Autoimmune polyendocrine syndrome type 2[40]	Moderate, A		258.1	DQ2, DQ8 and DRB1*0404. Autoantibodies: anti-21 hydroxylase, anti-17 hydroxylase. Synonyms: Schmidt syndrome, Polyglandular Autoimmune Syndrome 2, PGAS-2, APS Type 2
Autoimmune polyendocrine syndrome type 3	Moderate, A		258.1	Synonyms: Polyglandular Autoimmune Syndrome 3, PGAS-3, APS Type 3
Pancreas<Top>
Autoimmune pancreatitis	Moderate, A		577.1	Autoantibodies: ANA; anti-lactoferrin antibodiesanti-carbonic anhydrase antibodies; rheumatoid factor.
Diabetes mellitus type 1[15]	Moderate, A	IV	250.01	HLA-DR3, HLA-DR4. Autoantibodies: Glutamic acid decarboxylase antibodies (GADA), islet cell antibodies (ICA), and insulinoma-associated autoantibodies (IA-2), anti-insulin antibodies.
Thyroid Gland<Top>
Autoimmune thyroiditis	Strong, A	IV	245.8	HLADR5, CTLA-4. Autoantibodies: antibodies against thyroid peroxidase and/or thyroglobulin. Synonyms: chronic lymphocytic thyroiditis, Hashimoto's thyroiditis
Ord's thyroiditis	Moderate, Y		245.8
Graves' disease[15]	Moderate, M, A	II	242.0	Autoantibodies: thyroid autoantibodies (TSHR-Ab) that activate the TSH-receptor (TSHR).
Exocrine<Top>
Reproductive Organs<Top>
Autoimmune Oophoritis	Moderate, N		614.2
Endometriosis[41]	Limited, S		617.0
Autoimmune orchitis	Limited, N		604.0
Salivary Glands<Top>
Sjogren's syndrome[15][21][22][23]	Moderate, A		710.2	Autoantibodies: anti-Ro. Also, they are often present in Sjogren's syndrome..
Digestive System<Top>
Autoimmune enteropathy	Moderate, X, Y
Celiac disease[42][43][44]	Moderate, A,E	IV??	579.0	HLA-DQ8 and DQ2.5. Autoantibodies: Anti-tissue transglutaminase antibodies anti-endomysial IgA, anti-gliadin IgA.
Crohn's disease[45]	Moderate, Y	IV	555	Innate immunity; Th17; Th1; ATG16L1; CARD15;XBP1;.
Microscopic colitis	Limited, S		558.9
Ulcerative colitis[15]	Limited, A	IV	556
Tissue<Top>
Blood<Top>
Antiphospholipid syndrome[15]	Moderate, M, A		289.81	HLA-DR7, HLA-B8, HLA-DR2, HLA-DR3. Autoantibodies: anti-cardiolipin;anti pyruvate dehydrogenase; β2 glycoprotein I; phosphatidylserine; anti apoH; Annexin A5.
Aplastic anemia	Limited, F, Y		284
Autoimmune hemolytic anemia	Moderate, M, A	II	283.0	complement activation.
Autoimmune lymphoproliferative syndrome	Moderate, A		279.41	TNFRSF6; defective Fas-CD95 apoptosis. Synonyms: Canale-Smith Syndrome
Autoimmune neutropenia	Moderate, F, N		288.09
Autoimmune thrombocytopenic purpura[15]	Moderate, M, R, A		287.31	Autoantibodies: anti gpIIb-IIIa or 1b-IX. Synonyms: Idiopathic Thrombocytopenic Purpura
Cold agglutinin disease	Moderate, M, A	II	283.0	idiopathic or secondary to leukemia or infection. Autoantibodies: IgM. Synonyms: Autoimmune hemolytic anemia?
Essential mixed cryoglobulinemia	Limited, C, Y		273.2
Evans syndrome	Moderate, Y		287.32	Synonyms: A synonym for a combination of hemolytic anemia and thrombocytopenic purpura
IgG4-related systemic disease	Limited, C, N
Paroxysmal nocturnal hemoglobinuria	Limited, F, S		283.2
Pernicious anemia[46]	Moderate, A	II	281.0	Autoantibodies: anti-parietal cell antibody.
Pure red cell aplasia	Limited, Y		284.81
Thrombocytopenia[47][48]	Limited, F, Y	II	287.5	Multiple mechanisms. Autoantibodies: glycoproteins IIb-IIIa or Ib-IX in ITP anti-ADAMTS13 in TTP. and HUS anti-cardiolipin (anti-cardiolipin antibodies) and β2 glycoprotein I in Antiphospholipid syndrome anti-HPA-1a, anti-HPA-5b, and others in NAIT. Synonyms: Neonatal thrombocytopenia
Connective Tissue, Systemic, and multi-organ<Top>
Adiposis dolorosa[49]	Limited, L, S		272.8	Lipoid tissue. Synonyms: Dercum's disease
Adult-onset Still's disease[50]	Moderate, Y		714.2	macrophage migration inhibitory factor. Autoantibodies: ANA.
Ankylosing Spondylitis[26][27]	Limited, S		720.0	CD8; HLA-B27.
CREST syndrome	Limited, Y		710.1	Autoantibodies: Anti-centromere antibodies Anti-nuclear antibodies.
Drug-induced lupus	Moderate, Y		710.0	Autoantibodies: Anti-histone antibodies.
Enthesitis-related arthritis[51][52][53][54]	Limited, C, Y			MMP3, TRLR2, TLR4, ERAP1. Autoantibodies: .. Synonyms: A subtype of Juvenile Rheumatoid Arthritis
Eosinophilic fasciitis	Limited, F, A		728.89	Synonyms: Shulman's syndrome
Felty syndrome[55]	Strong, M, Y		714.1
Juvenile Arthritis[50]	Strong, M, R, Y		714.30	Autoantibodies: inconsistent ANA Rheumatoid factor. Synonyms: Juvenile rheumatoid arthritis, Juvenile idiopathic arthritis
Lyme disease (Chronic)[56]	Limited, L, T, N		088.81
Mixed connective tissue disease[15]	Moderate, M, A		710.8	HLA-DR4. Autoantibodies: anti-nuclear antibody anti-U1-RNP.
Palindromic rheumatism[57]	Limited, Y		719.3	Autoantibodies: anti-cyclic citrullinated peptide antibodies (anti-CCP) and antikeratin antibodies (AKA). Synonyms: Hench-Rosenberg syndrome
Parry Romberg syndrome	Limited, Y		349.89351.8	Autoantibodies: ANA.
Parsonage-Turner syndrome	Limited, Y		353.5
Psoriatic arthritis[58]	Moderate, C, A	IV?	696.0	HLA-B27.
Reactive arthritis	Limited, C, F, Y		099.3	Synonyms: Reiter's syndrome
Relapsing polychondritis[59]	Strong, A		733.99	Synonyms: atrophic polychondritis, systemic chondromalacia, chronic atrophic polychondritis, Meyenburg-Altherr-Uehlinger syndrome, generalized chondromalacia, systemic chondromalacia
Retroperitoneal fibrosis	Limited, Y		593.4
Rheumatic fever[60][61]	Moderate, T, A	II	390	Autoantibodies: streptococcal M protein cross reacts with human myosin.
Rheumatoid arthritis[15]	Strong, M, A	III	714	HLA-DR4, PTPN22, depleted B cells, TNF alpha, IL-17, (also maybe IL-1, 6, and 15). Autoantibodies: Rheumatoid factor (anti-IgGFc), Anti-MCV, ACPAs(Vimentin).
Sarcoidosis[62][63][64]	Limited, S	IV	135	BTNL2; HLA-B7-DR15; HLA DR3-DQ2.
Schnitzler syndrome	Limited, L, X, Y		273.1	IgM?.
Systemic Lupus Erythematosus[15][21][22][23][31][65]	Strong, M, A	III	695.4	Autoantibodies: Anti-nuclear antibodies anti-Ro. Also, they are often present in Sjogren's syndrome. Eosinophilia. Synonyms: Lupus
Undifferentiated connective tissue disease	Moderate, C, A		710.9	HLA-DR4. Autoantibodies: anti-nuclear antibody. Synonyms: Latent lupus, incomplete lupus
Muscle<Top>
Dermatomyositis[66][67]	Moderate, F, X, A		710.3	B- and T-cell perivascular inflammatory infiltrate on muscle biopsy. Autoantibodies: histidine-tRNA anti-signal recognition peptide Anti-Mi-2 Anti-Jo1.. Synonyms: Juvenile dermatomyositis
Fibromyalgia	Limited, C, F, N		729.1
Inclusion body myositis	Limited, F, Y		359.71	Similar to polymyositis but does not respond to steroid therapy-activated T8 cells.
Myositis	Limited, F, Y		729.1
Myasthenia gravis[15]	Strong, M, A	II	358	HA-B8 HLA-DR3 HLA-DR1. Autoantibodies: nicotinic acetylcholine receptor MuSK protein.
Neuromyotonia[68]	Limited, F, S	II?	333.90	Autoantibodies: Voltage-gated potassium channels. Synonyms: Isaacs' Syndrome
Paraneoplastic cerebellar degeneration[69][70][71]	Limited, Y	IV? II?	334.9	Autoantibodies: anti-Yo (anti-cdr-2 in purkinje fibers) anti-Hu, anti-Tr, antiglutamate receptor.
Polymyositis[66]	Limited, F, A		710.4	Autoantibodies: IFN-gamma, IL-1, TNF-alpha.
Nervous System<Top>
Acute disseminated encephalomyelitis	Strong, M, T, A		323.61323.81	Synonyms: ADEM, Perivenous encephalomyelitis, Acute hemorrhagic leukoencephalitis, AHL, AHLE, acute necrotizing encephalopathy (ANE), acute hemorrhagic encephalomyelitis (AHEM), acute necrotizing hemorrhagic leukoencephalitis (ANHLE), Weston-Hurst syndrome, Hurst's disease
Acute motor axonal neuropathy[72]	Limited, N		356.8
Anti-N-Methyl-D-Aspartate Receptor Encephalitis[73]	Moderate, N			Synonyms: Anti-NMDA Encephalitis
Balo concentric sclerosis	Moderate, Y		341.1	Synonyms: Balo disease, Schilders disease
Bickerstaff's encephalitis	Limited, Y		323.62	similar to Guillain-Barré syndrome. Autoantibodies: Anti-GQ1b 2/3 patients.
Chronic inflammatory demyelinating polyneuropathy[74]	Moderate, C, Y		357.81	similar to Guillain–Barré syndrome. Autoantibodies: anti-ganglioside antibodies. Synonyms: Relapsing polyneuropathy (CRP), chronic inflammatory demyelinating polyradiculoneuropathy, Chronic inflammatory demyelinating polyneuritis
Guillain–Barré syndrome[15]	Strong, M, A	IV	357.0	Autoantibodies: Anti-ganglioside, anti-GQ1b. Synonyms: Miller-Fisher syndrome, Landry's paralysis
Hashimoto's encephalopathy[15][75]	Moderate, C, X, A	IV		Autoantibodies: alpha-enolase. Synonyms: Steroid-responsive encephalopathy associated with autoimmune thyroiditis, SREAT, Nonvasculitic autoimmune meningoencephalitis, NAIM, Encephalopathy Associated with Autoimmune Thyroid Disease, EAATD
Idiopathic inflammatory demyelinating diseases	Limited, F, Y		356.8	A set of different variants of multiple sclerosis.
Lambert-Eaton myasthenic syndrome	Strong, M, Y		358.1	HLA-DR3-B8. Autoantibodies: voltage-gated calcium channels; Q-type calcium channel, synaptogagmin, muscarinic acetylcholine receptor M1.
Multiple sclerosis, pattern II[76][76][77]	Strong, M, A	IV	340	Autoantibody against potassium channel has been reported to present demyelination pattern II. Other cases present autoimmunity against MOG[78] and Anoctamin-2.[79] The three reported autoimmune variants belong to MS pattern II. Also involved HLA-DR2, PECAM-1, Anti-myelin basic protein. Autoantibodies: Anti-Kir4.1, Anti-MOG, Anti-ANO2 (heterogeneous). Synonyms: Primary progressive multiple sclerosis, Relapsing-remitting multiple sclerosis, disseminated sclerosis, encephalomyelitis disseminata
Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus	Limited, F, S	II?	279.49	antibodies against streptococcal infection serve as auto-antibodies. Synonyms: PANDAS
Progressive inflammatory neuropathy	Limited, X, S		356.4	similar to Guillain-Barré syndrome. Autoantibodies: Anti-ganglioside antibodies:anti-GM1, anti-GD1a, anti-GQ1b.
Restless leg syndrome	Limited, C, S		333.94	May occur in Sjogren's syndrome, celiac disease, and rheumatoid arthritis or in derangements of iron metabolism.
Stiff person syndrome[80]	Limited, S		333.91	GLRA1 (glycine receptor). Autoantibodies: glutamic acid decarboxylase (GAD).
Sydenham chorea	Limited, T, Y		392
Transverse myelitis	Limited, M, A		323.82341.2
Eyes<Top>
Autoimmune retinopathy[81]	Limited, X, N
Autoimmune uveitis	Moderate, F, A		364	Autoantibodies: HLAB-27?.
Cogan syndrome	Limited, F, Y		370.52
Graves ophthalmopathy	Moderate, M, N		242.9
Intermediate uveitis	Limited, L, Y		364.3	Synonyms: Pars planitis, Peripheral Uveitis
Ligneous conjunctivitis	Limited, L, N		372.39
Mooren's ulcer	Limited, L, N		370.07
Neuromyelitis optica[82][83]	Limited, M, Y	II?	341.0	Autoantibodies: NMO-IgG aquaporin 4. Synonyms: Devic's disease
Opsoclonus myoclonus syndrome[84]	Limited, X, S	IV?	379.59	Lymphocyte recruitment to CSF.
Optic neuritis	Limited, C, Y		377.30
Scleritis	Limited, C, Y		379.0
Susac's syndrome	Limited, C, Y		348.39	Synonyms: Retinocochleocerebral Vasculopathy
Sympathetic ophthalmia	Limited, I, Y		360.11	Autoantibodies: ocular antigens following trauma.
Tolosa-Hunt syndrome	Limited, I, X, Y		378.55
Ears<Top>
Autoimmune inner ear disease[85]	Limited, A		388.8	Synonyms: AIED
Ménière's disease[86]	Limited, Y	III?	386.00	Autoantibodies: major peripheral myelin protein P0.
Vascular system<Top>
Anti-neutrophil cytoplasmic antibody-associated vasculitis[87]	Strong, M, A		447.6	Autoantibodies: Anti-neutrophil cytoplasmic(cANCA). Synonyms: Wegener Granulomatosis, Granulomatosis with Polyangiitis
Behçet's disease	Limited, I, X, A		136.1	immune-mediated systemic vasculitis; linkage to HLA-B51 (HLA-B27); very different manifestations with ulcers as common symptom. Synonyms: Morbus Adamandiades-Behçet. Rare Variant: Hughes-Stovin syndrome
Churg-Strauss syndrome[31]	Limited, I, X, Y		446.4	Autoantibodies: p-ANCA Eosinophilia.
Giant cell arteritis [15]	Limited, I, R, A	IV	446.5	Synonyms: Cranial arteritis, Temporal Arteritis
Henoch-Schonlein purpura	Limited, L, Y		287.0	Autoantibodies: immunoglobulin A (IgA) and complement component 3 (C3). Synonyms: anaphylactoid purpura, purpura rheumatica, Schönlein–Henoch purpura
Kawasaki's disease	Moderate, S,E[88]		446.1	ITPKC HLA-B51. Synonyms: Kawasaki syndrome, lymph node syndrome, mucocutaneous lymph node syndrome
Leukocytoclastic vasculitis	Limited, L, Y		447.6
Lupus vasculitis	Moderate, C, N		583.81	A comorbidity of Systemic Lupus Erythematosis.
Rheumatoid vasculitis	Moderate, C, N		447.6	A symptom of Lupus.
Microscopic polyangiitis	Limited, Y		446.0	Binds to neutrophils causing them to degranulate and damages endothelium. Autoantibodies: p-ANCA myeloperoxidase. Synonyms: microscopic polyarteritis,microscopic polyarteritis nodosa, MPA
Polyarteritis nodosa	Limited, L, Y		446.0	Synonyms: panarteritis nodosa, periarteritis nodosa, Kussmaul disease, Kussmaul-Maier disease
Polymyalgia rheumatica	Limited, L, Y		725
Urticarial vasculitis[89]	Limited, X, Y	II?	708.9	Clinically may resemble type I hypersensitivity. Autoantibodies: anti C1q antibodies.
Vasculitis[30]	Strong, I, M, F, A	III	447.6	Autoantibodies: sometimes ANCA.

Autoimmune Comorbidities

This list includes conditions that are not diseases but signs common to autoimmune disease. Some, such as Chronic Fatigue Syndrome, are controversial.^[13] These conditions are included here because they are frequently listed as autoimmune diseases but should not be included in the list above until there is more consistent evidence.

Organ/Tissue Type Disease Name	Level of Acceptance for Autoimmunity	Hypersensitivity (I,II,III,IV)	ICD-9 Codes	Notes/Autoantibodies/Synonyms
Chronic fatigue syndrome	Comorbidity, N			Symptomatic of autoimmune diseases or autoimmune activity, but not a disease or a cause of disease.
Complex regional pain syndrome	Comorbidity, N			Symptomatic of autoimmune diseases or autoimmune activity, but not a disease or a cause of disease. Synonyms: Amplified Musculoskeletal Pain Syndrome, Reflex Neurovascular Dystrophy, Reflex sympathetic dystrophy
Eosinophilic esophagitis	Comorbidity, N		530.13
Gastritis	Comorbidity, Y			Possibly symptomatic of autoimmune diseases, but not a disease or a cause of disease. Autoantibodies: serum antiparietal and anti-IF antibodies.
POEMS syndrome[90]	Comorbidity, Y			Possibly symptomatic of autoimmune diseases, but not a disease or a cause of disease. Autoantibodies: interleukin 1β, interleukin 6 and TNFα. vascular endothelial growth factor (VEGF), given the ..
Raynaud's phenomenon	Comorbidity, S			Symptomatic of autoimmune diseases or autoimmune activity, but not a disease or a cause of disease.
Primary immunodeficiency[91]	Comorbidity, N		279.8	The condition is inherited, but it is associated with several autoimmune diseases.
Pyoderma gangrenosum	Comorbidity, Y			Possibly symptomatic of autoimmune diseases, but not a disease or a cause of disease.

Not Autoimmune

At this time, there is not sufficient evidence - direct, indirect, or circumstantial - to indicate that these diseases are caused by autoimmunity. These conditions are included here because:

1. The disease was listed in the prior version of this table
2. The disease is included in several widely used lists of autoimmune disease. It is included here to ensure that a person visiting this page does not conclude that the disease was not considered. Before moving a condition from here to the list of autoimmune diseases, references should be provided in the Wikipedia page for the condition that point to evidence of autoimmunity.

Organ/Tissue Type Disease Name	Level of Acceptance for Autoimmunity	Hypersensitivity (I,II,III,IV)	ICD-9 Codes	Notes/Autoantibodies/Synonyms
Agammaglobulinemia	Not Autoimmune, Y		279.00	An immune system disorder but not an autoimmune disease.. Autoantibodies: IGHM; IGLL1: CD79A; CD79B; BLNK; LRRC8A.
Amyloidosis	Not Autoimmune, N		277.30	No consistent evidence of association with autoimmunity.
Amyotrophic lateral sclerosis	Not Autoimmune, Y		335.20	No consistent evidence of association with autoimmunity. Autoantibodies: Amyotrophic lateral sclerosis (Also Lou Gehrig's disease; Motor Neuron Disease).
Anti-tubular basement membrane nephritis	Not Autoimmune, N			No consistent evidence of association with autoimmunity.
Atopic allergy	Not Autoimmune, Y	I	691.8	A hypersensitivity.
Atopic dermatitis	Not Autoimmune, Y	I	691.8	A hypersensitivity.
Autoimmune peripheral neuropathy	Not Autoimmune, F, A			A class of diseases, some of which may be autoimmune. See specific diseases that are listed as autoimmune..
Blau syndrome	Not Autoimmune, Y			Overlaps both sarcoidosis and granuloma annulare. No evidence of association with autoimmunity.
Cancer	Not Autoimmune, Y			No consistent evidence of association with autoimmunity.
Castleman's disease	Not Autoimmune, Y			An immune system disorder but not an autoimmune disease.. Autoantibodies: Over expression of IL-6.
Chagas disease[92]	Not Autoimmune, S			No consistent evidence of association with autoimmunity.
Chronic obstructive pulmonary disease[93][94]	Not Autoimmune, S			No consistent evidence of association with autoimmunity.
Chronic recurrent multifocal osteomyelitis	Not Autoimmune, Y			LPIN2, D18S60. Synonyms: Majeed syndrome
Complement component 2 deficiency	Not Autoimmune, Y			Possibly symptomatic of autoimmune diseases, but not a disease.
Congenital heart block	Not Autoimmune, N			May be related to autoimmune activity in the mother.
Contact dermatitis	Not Autoimmune, Y	IV		A hypersensitivity.
Cushing's syndrome	Not Autoimmune, Y			No consistent evidence of association with autoimmunity.
Cutaneous leukocytoclastic angiitis	Not Autoimmune, Y			No consistent evidence of association with autoimmunity. Autoantibodies: neutrophils.
Dego's disease	Not Autoimmune, Y			No consistent evidence of association with autoimmunity.
Eczema[95][96][97]	Not Autoimmune, Y			No consistent evidence of association with autoimmunity. Autoantibodies: LEKTI, SPINK5, filaggrin., Brain-derived neurotrophic factor (BDNF) and Substance P..
Eosinophilic gastroenteritis	Not Autoimmune, Y			Possibly a hypersensitivity. Autoantibodies: IgE, IL-3, IL-5, GM-CSF, eotaxin.
Eosinophilic pneumonia	Not Autoimmune, F, Y			A class of diseases, some of which may be autoimmune. Specifically, Churg-Strauss syndrome, a subtype of Eosinophilic pneumonia, is autoimmune.
Erythroblastosis fetalis	Not Autoimmune, Y	II		Mother's immune system attacks fetus. An immune system disorder but not autoimmune. Autoantibodies: ABO, Rh, Kell antibodies.
Fibrodysplasia ossificans progressiva	Not Autoimmune, Y			Possibly an immune system disorder but not autoimmune. Autoantibodies: ACVR1 Lymphocytes express increased BMP4.
Gastrointestinal pemphigoid	Not Autoimmune, A			No consistent evidence of association with autoimmunity.
Hypogammaglobulinemia	Not Autoimmune, Y			An immune system disorder but not autoimmune. Autoantibodies: IGHM, IGLL1, CD79A, BLNK, LRRC8A, CD79B.
Idiopathic giant-cell myocarditis[98]	Not Autoimmune, N			No consistent evidence of autoimmune cause though the disease has been found comorbid with other autoimmune diseases. Synonyms: Giant cell myocarditis
Idiopathic pulmonary fibrosis[99][99]	Not Autoimmune, Y			Autoantibodies: SFTPA1, SFTPA2, TERT, and TERC.. Synonyms: Fibrosing alveolitis
IgA nephropathy	Not Autoimmune, Y	III?		Autoantibodies: IgA produced from marrow rather than MALT. Synonyms: IgA nephrits, Berger's disease, Synpharyngitic Glomerulonephritis. An immune system disorder but not an autoimmune disease.
Immunoregulatory lipoproteins[100]	Not Autoimmune, N			Not a disease.
IPEX syndrome	Not Autoimmune, N			A genetic mutation in FOXP3 that leads to autoimmune diseases, but no consistent evidence that it is an autoimmune disorder itself.. Synonyms: X-linked polyendocrinopathy, immunodeficiency and diarrhea-syndrome (XLAAD)
Ligneous conjunctivitis	Not Autoimmune, N			No consistent evidence of association with autoimmunity.
Majeed syndrome	Not Autoimmune, Y			No consistent evidence of association with autoimmunity. Autoantibodies: LPIN2.
Narcolepsy[101][102][103][104]	Not Autoimmune, Y	II?		No evidence of association with autoimmunity. Research not reproducible. Autoantibodies: hypocretin or orexin, HLA-DQB1*0602.
Rasmussen's encephalitis	Not Autoimmune, Y			No consistent evidence of association with autoimmunity. Autoantibodies: anti-NR2A antibodies.
Schizophrenia[105][106][107]	Not Autoimmune, S			No consistent evidence of association with autoimmunity.
Serum sickness	Not Autoimmune, Y	III		A hypersensitivity.
Spondyloarthropathy	Not Autoimmune, Y			No consistent evidence of association with autoimmunity. Autoantibodies: HLA-B27.
Sweet's syndrome	Not Autoimmune, Y			No consistent evidence of association with autoimmunity. Autoantibodies: GCSF.
Takayasu's arteritis	Not Autoimmune, Y			No consistent evidence of association with autoimmunity.
Undifferentiated spondyloarthropathy	Not Autoimmune, Y			See Enthesitis-related arthritis.

Development of therapies

In both autoimmune and inflammatory diseases, the condition arises through aberrant reactions of the human adaptive or innate immune systems. In autoimmunity, the patient's immune system is activated against the body's own proteins. In chronic inflammatory diseases, neutrophils and other leukocytes are constitutively recruited by cytokines and chemokines, leading to tissue damage.

Mitigation of inflammation by activation of anti-inflammatory genes and the suppression of inflammatory genes in immune cells is a promising therapeutic approach.^{[108][109][110]}

See also

• Autoimmunity
• Immune-mediated disease

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Further reading

• Vinay Kumar, Abul K. Abbas, Nelson Fausto, Jon Aster, Robbins and Cotran Pathologic Basis of Disease, Elsevier, 8th edition, 2010, 1464 pp., ISBN 978-1-4160-3121-5
• Handbook of Systemic Autoimmune Diseases, edited by Ronald Asherson, Elsevier, in 10 Volumes: http://www.elsevier.com/wps/find/bookdescription.cws_home/BS_HSAD/description#description
  • Ronald Asherson, Andrea Doria, Paolo Pauletto, The Heart in Systemic Autoimmune Diseases, Volume 1, 2004, ISBN 978-0-444-51398-4, ISBN 0-444-51398-1
  • Ronald Asherson, Andrea Doria, Paolo Pauletto, Pulmonary Involvement in Systemic Autoimmune Diseases, Volume 2, 2005, ISBN 978-0-444-51652-7, ISBN 0-444-51652-2
  • Ronald Asherson, Doruk Erkan, Steven Levine, The Neurologic Involvement in Systemic Autoimmune Diseases, Volume 3, 2005, ISBN 978-0-444-51651-0, ISBN 0-444-51651-4
  • Michael Lockshin, Ware Branch (eds), Reproductive and Hormonal Aspects of Systemic Autoimmune Diseases, Volume 4, 2006, ISBN 978-0-444-51801-9, ISBN 0-444-51801-0
  • Piercarlo Sarzi-Puttini, Ronald Asherson, Andrea Doria, Annegret Kuhn, Giampietro Girolomoni (eds), The Skin in Systemic Autoimmune Diseases, Volume Volume 5, 2006, ISBN 978-0-444-52158-3, ISBN 0-444-52158-5
  • Rolando Cimaz, Ronald Asherson, Thomas Lehman (eds), Pediatrics in Systemic Autoimmune Diseases, Volume 6, 2008, ISBN 978-0-444-52971-8, ISBN 0-444-52971-3
  • Justin Mason, Ronald Asherson, Charles Pusey (eds), The Kidney in Systemic Autoimmune Diseases, Volume 7, 2008, ISBN 978-0-444-52972-5, ISBN 0-444-52972-1
  • Ronald Asherson, Manel Ramos-Casals, Joan Rodes, Josep Font, Digestive Involvement in Systemic Autoimmune Diseases, Volume 8, 2008, ISBN 978-0-444-53168-1, ISBN 0-444-53168-8
  • Ronald Asherson, Sara Walker, Luis Jara, Endocrine Manifestations of Systemic Autoimmune Diseases, Volume 9, 2008, ISBN 978-0-444-53172-8, ISBN 0-444-53172-6
  • R. Cervera, Ronald Asherson, Munther Khamashta, Joan Carles Reverter (eds), Antiphospholipid Syndrome in Systemic Autoimmune Diseases, Volume 10, 2009, ISBN 978-0-444-53169-8, ISBN 0-444-53169-6
• www.autoimmunityblog.com - a glossary of autoimmune diseases and the related autoantibodies plus summaries of recent research articles.

External links

• Autoimmune disorders at DMOZ