Immunologic Research

, Volume 56, Issue 2–3, pp 425–431 | Cite as

Detecting multiple autoantibodies to diagnose autoimmune co-morbidity (multiple autoimmune syndromes and overlap syndromes): a challenge for the autoimmunologist

  • Renato Tozzoli
  • Maria Concetta Sorrentino
  • Nicola Bizzaro
Diagnosis of Autoimmunity


In the last 15 years, the estimated prevalence of autoimmune diseases increased from about 4 to 9.4 %. Autoimmune co-morbidity (i.e., the association between two or more autoimmune diseases in the same patient) is present in 0.4–0.5 % of the worldwide population, more frequently in patients with multiple sclerosis, rheumatoid arthritis, autoimmune thyroid disease, type 1 diabetes, inflammatory bowel disease and vitiligo. The most common associations between autoimmune diseases define two clusters: the multiple autoimmune syndromes and overlap syndromes. This review highlights the importance of multiple antibody assays in the diagnosis of multiple autoimmune and overlap syndromes and summarizes the general conditions of autoantibody detection using the model of the five W’s: why, who, what, when and where. These conditions represent a new challenge for clinical and laboratory autoimmunologists, who, in a multidisciplinary arena, cooperate in investigating and treating multiple autoimmune disorders.


Autoimmunology Multiple autoimmune syndromes Overlap syndromes Autoimmune liver diseases Connective tissue diseases Co-morbidity Polyautoimmunity 


Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Renato Tozzoli
    • 1
  • Maria Concetta Sorrentino
    • 2
  • Nicola Bizzaro
    • 3
  1. 1.Department of Laboratory Medicine, S. Maria degli Angeli HospitalPordenoneItaly
  2. 2.Laboratory of Clinical Pathology, Mediterranean Institute for Transplants and High Specialty TherapiesPalermoItaly
  3. 3.Laboratory of Clinical Pathology, San Antonio HospitalTolmezzoItaly

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