Abstract
Multiple autoimmune syndrome is the association of three or more autoimmune diseases in the same patient. We report the case of a 24-year-old woman with a medical past history of celiac disease since the age of 3. She complained of fatigue, malar rash, and paresthesia of the lower limbs. Physical examination objectified fever at 38°C and butterfly rash. Cell blood count showed leucopenia and lymphopenia. Thyroid tests concluded to primary hypothyroidism. Immunological investigations revealed positive antinuclear antibodies (1/3200), anti-DNA, and thyroperoxydase antibodies. The HLA haplotype typing was A1 A26 B50 B16 DR3 DR52 DQ2. The diagnosis of multiple autoimmune syndrome associating systemic lupus erythematosus, celiac diasese, and Hashimoto’s thyroiditis was retained. The patient was treated with hydroxychloroquine 400 mg/day and L-thyroxine 100 µg/day. The global outcome was favorable and the patient was free of symptoms. The decline is 10 years. The current case is unique in this aspect that the combination of these three autoimmune disorders has rarely been reported in the past.
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