Multiple Autoimmune Syndrome (MAS)

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Clinically Relevant Anatomy

Multiple autoimmune syndrome is a condition in which a minimum of three distinct autoimmune diseases have been diagnosed in a person..Autoimmune diseases are chronic disabling conditions that occur when a persons own immune systems turns on itself. Any once healthy cells, tissues and organs can be involved and can lead to a diverse set of changes within the body depending on the autoimmune disease that is diagnosed. Examples of autoimmune disease are; fibromyalgia; HIV/AIDS; 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.

A three group classification has been developed which clusters together the autoimmune diseases that tend to occur together.

1.MAS includes myasthenia gratis, thymoma, polymyositis and giant cell myocarditis

2.MAS includes Sjogren's syndrome, RA, scleroderma, autoimmune thyroid disease .

3.MAS includes SLE, DM1, Sjogren's syndrome, Addison's disease, vitiligo, dermatitis herpetiformis, autoimmune thyroid disease.

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, pain, fatigue, inflammation, isolation and depression can all be addressed. Tailored physical activity programs are a fantastic way to improve every levels, decrease stress , increased sense of well being and the myriad of physiological benefits. Specific, general and holistic techniques can be employed eg individual tailored exercise programs, pain education, hydrotherapy, energy conservation, diet plans and advice, group exercise participation, goal orientated activities.

In conclusion note that is important with chronic life changing diseases to take a holistic approach including specific and varied physiotherapy skills, good patient education and family/ carers inclusion.

Resources

see autoimmune disorders resources