Autoimmune diseases M35.9

• Diseases that are characterized by disorders of the immune system. In autoimmune diseases, a wrong targeting or programming leads to an alignment against the body's own tissues: instead of fighting potentially disease-causing germs, parts of the own body are regarded as "foreign" and are fought. Autoimmune diseases can affect any organ of the human body, depending on the "target". In the model of molecular mimicry it is assumed that an immune response is postulated which is actually directed against a pathogen (e.g. against a bacterium), but is directed against the body's own structures in the sense of a cross-reaction. The classic model for this is rheumatic fever. Here, a cross-reaction of strepotococcal antigens with the sarcolemma of the heart muscle is assumed. Autoantibodies can be detected in a variety of autoimmune diseases. It is important whether these autoantibodies have only an accompanying function or a functional significance.
• Autoimmune diseases can persist for life without treatment or until the target structure is completely destroyed. However, spontaneous healings are possible.

From a clinical point of view, it is useful to divide autoimmune diseases into organ-specific and non-organ-specific (systemic) autoimmune diseases:

• Organ specific autoimmune diseases:
  • Endocrine system:
    • Hashimoto's thyroiditis
    • M. Basedow
    • type 1 diabetes
    • Addison, M.
  • Hepatobiliary system/gastrointestinal tract:
    • Autoimmune hepatitis
    • Primary biliary cirrhosis
    • Sclerosing cholangitis
    • Gluten Sensitive Enteropathy
    • Pernicious anemia
    • M. Crohn (Enteritis regionalis)
    • Ulcerative colitis.
  • skin:
    • Autoimmune dermatoses, bullous
    • Autoimmune progesterone dermatitis in pregnancy
    • Vitiligo
    • alopecia areata
    • lichen sclerosus et atrophicus
    • Lichen planus.
  • Hematological system:
    • Autoimmune hemolytic anemia (see also Evans syndrome)
    • Purpura, idiopathic thrombocytopenic (M. Werlhof)
    • Autoimmune neutropenia.
  • Neuromuscular system:
    • Myasthenia gravis
    • multiple sclerosis
    • Guillain-Barre syndrome.
• Non-organ specific (systemic) autoimmune diseases:
  • Collagenosis and inflammatory arthritis:
    • Lupus erythematosus
    • Dermatomyositis
    • Scleroderma
    • Mixed collagenoses
    • Polyarthritis, chronic
    • Sjögren's Syndrome
    • Graft-versus-host disease.
  • vasculitides:
    • Polyarteritis nodosa
    • Churg-Strauss Syndrome
    • Wegener's granulomatosis
    • temporal arteritis
    • Takayasu arteritis
    • Kawasaki Syndrome
    • endangiitis obliterans
    • Cryoglobulinemia.

Approximately 290 loci are associated with autoimmune diseases in which SNPs (single nucleotide polymorphisms) are detectable in clusters. Remarkably, among these loci there is also a significant clustering of loci associated with allergies (Kreiner et al. 2017).

1. Bar-Meier E et al (2003) Silicone gel breast implants and connective tissue disease-a comprehensive review. Autoimmunity 36: 193-197

2. Kreiner E et al (2017) Shared genetic variants suggest common pathways in allergy and autoimmune diseases
   . J Allergy Clin Immunol 140:771-781.