Multiple Autoimmune Syndrome (MAS)

Original Editor - User:Lucinda hampton Top Contributors - Lucinda hampton, Kim Jackson, Leana Louw, Vidya Acharya and Rishika Babburu

Multiple Autoimmune Syndrome (MAS): Quick Guide for Physiotherapists

MAS is the coexistence of three or more autoimmune diseases, when a patient has 3 or more different autoimmune diseases at the same time.

The Three Types (Classic Classification). MAS is classified into three groups based on how often they occur with two autoimmune diseases. This classification helps when a third disorder's symptoms arise.

MAS Type 1 - Muscle & Heart Focus

• Myasthenia gravis
• Polymyositis
• Giant cell myocarditis
• Thymoma

MAS Type 2 - Joints & Glands

• Rheumatoid arthritis
• Sjögren's syndrome
• Scleroderma
• Autoimmune thyroid disease

MAS Type 3 - Mixed Bag

• Lupus (SLE)
• Type 1 diabetes
• Sjögren's syndrome
• Addison's disease
• Vitiligo
• Autoimmune thyroid disease

Why This Matters?

• 1 in 4 people with one autoimmune disease develop another
• Always screen for additional conditions when treating autoimmune patients
• Complex symptoms require holistic treatment approach
• Fatigue, pain, and inflammation are common across all types

Clinical Red Flag

If your patient reports having any autoimmune condition, make sure to inquire about other conditions and symptoms. This approach can help identify patterns that may be relevant.

Bottom line: MAS = Multiple conditions, multiple challenges, but targeted physiotherapy can still make a huge difference. Examples of autoimmune diseases are; fibromyalgia; Human Immunodeficiency Virus (HIV); Lyme disease; Systemic Lupus Erythematosus; Rheumatoid Arthritis; Psoriatic Arthritis.

Mechanism of Injury / Pathological Process

The pathogenesis of MAS is unclear but to date environmental, infectious, psychological, genetic, and immunologic susceptibility are being investigated.

Clinical Presentation

When a person presents to physiotherapy for treatment related to an autoimmune disease or has a diagnosis of an autoimmune disease in their medical history, be sure to check for the possibility of others [further investigations may be warranted]. This is important as up to one in four persons with an autoimmune disease has a tendency to develop another For clinical presentation of specific autoimmune diseases follow the former link

Outcome Measures

The outcome measures chosen will vary depending on the autoimmune diseases present.

(see individual autoimmune condition outcome measures)

Management / Interventions

For clients living with a chronic autoimmune disease physiotherapy can be immensely beneficial for the ailments associated with the condition.

For individual autoimmune diseases, the physiotherapy protocols will be the same but with MAS, a long term educational holistic view is warranted more than ever.

Symptoms such as joint swelling, muscle wasting, increased falls risk due to loss of neurological coordination, pain, fatigue, inflammation, isolation and depression can all be addressed.

Tailored physical activity programs are a fantastic way to improve energy levels, decrease stress , increased a persons sense of well being and a myriad of physiological benefits. Specific and general techniques can be employed eg individual tailored exercise programs, pain education, hydrotherapy, balance training, energy conservation, diet plans/ advice, group exercise participation, goal orientated activities.

A tailored walking program is often an option.

Conclusion

It is essential, with chronic, life-changing diseases, to take a holistic approach, including specific and varied physiotherapy skills, effective patient education, and family/carer inclusion.

Resources

https://www.autoimmune.org.au/

see autoimmune disorders resources