THE COEXISTENCE OF SYSTEMIC LUPUS-ERYTHEMATOSUS WITH OTHER AUTOIMMUNE-DISEASES - THE KALEIDOSCOPE OF AUTOIMMUNITY

Patients with systemic lupus erythematosis (SLE) often manifest featur es of other autoimmune diseases. In this review, we provide a detailed compendium of features of SLE that overlap with other conditions. Thi s compendium is important because a critical feature in our understand ing of autoimmunity has been the clustering of coexisting/different au toimmune diseases both within an affected patient and within a pedigre e. Indeed, autoimmune disorders share a variety of similar clinical an d serological defects. For example, all autoimmune disorders are assoc iated with the elaboration of autoantibodies and/or the production of self-reactive mononuclear cell populations; many have high levels of i mmune complexes and defects in cell-mediated immunity. Several disease s share similar genetic backgrounds, as reflected by study of loci wit hin the major histocompatibility complex. In part the coassociation is due to common genetic tendencies with different environmental precipi tating agents (trigger mechanisms). It is likely that many factors can modulate the immune system to autoimmunity in the presence of an appr opriate genetic background, eg, drugs, viral infections, UV irradiatio n, and toxins, ie, toxic oil syndrome and L-tryptophan-induced eosinop hilic myalgia. The coexistence of SLE with other autoimmune diseases i s an excellent venue to understand these events, and we believe that t he presence of other autoimmune diseases in patients with SLE can be c alled the kaleidoscope of autoimmunity. Copyright (C) 1994 by W.B. Sau nders Company