César Gamarra Ayarza^{1, 2,}, César Galvez López^{3, 4}, José Castro-Zevallos^{1, 2}, Manuel Silva Zumaran^{1, 2}, Ramón Flores Valdeiglesias^{1, 2}

Multiple autoimmune syndrome (MAS) is a form of polyautoimmunity that encompasses three or more autoimmune diseases with well-defined diagnostic criteria in the same individual, reflecting a shared genetic susceptibility and overlapping immunopathogenic mechanisms (autoimmune tautology) and alters the clinical and serological manifestations, as well as the prognosis of the diseases involved. Its association with chromosomal abnormalities such as DiGeorge syndrome (22q11.2 deletion syndrome) is uncommon. We present the case of a young woman with MAS which includes systemic lupus erythematosus, Sjögren's syndrome, and limited cutaneous systemic sclerosis with a DiGeorge syndrome phenotype (facial dysmorphism, mild cognitive impairment, dysthymia, and a history of cheiloplasty and palatoplasty for incomplete cleft palate). Her karyotype was normal, and her FISH test was negative, which did not rule out DiGeorge syndrome. It presents with severe lupus nephritis, pericarditis, pancytopenia and febrile neutropenia, with a poor clinical course. Its clinical and immunological characteristics and management are described, and a review of the medical literature is presented.

Multiple autoimmune syndrome (MAS), systemic lupus erythematosus (SLE), systemic sclerosis, Sjögren's syndrome, DiGeorge phenotype