Multiple Autoimmune Syndrome (MAS)

Original Editor - User:Lucinda hampton Top Contributors - Lucinda hampton, Kim Jackson and Leana Louw

Clinically Relevant Anatomy

Multiple autoimmune syndrome is a condition in which a minimum of three distinct autoimmune diseases have been diagnosed in a person.[1].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.

Anatomy pic.jpg

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.They are simply called Type 1 MAS Type 2 MAS or Type 3 MAS

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

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

Type 3 MAS includes SLE, DM1, Sjogren's syndrome, Addison's disease, vitiligo, dermatitis herpetiformis, autoimmune thyroid disease.[1]

Clinical PresentationJoint swelling.jpg


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[1] 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.[3]

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.[4]

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.[3]

A tailored walking program is often an option.


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.


see autoimmune disorders resources


  1. 1.0 1.1 1.2 Cojocaru M, Cojocaru IM, Silosi I. Multiple autoimmune syndrome. Maedica. 2010 Apr;5(2):132.
  2. Demystifying Medicine.What are autoimmune diseases. [last accessed 10/2/2019],
  3. 3.0 3.1 PDH academy.How can physical therapists help people with Autoimmune Disorders. 14.2.2018
  4. Jan Tregre, DPT, Southern Physical Therapy and Women’s Therapy Center. How physical therapy can help with autoimmune diseases. June 3 2014
  5. Michelle Spring.Walking is the perfect exercise for autoimmune diseases. Available from: [last accessed 11.2.2019]