# Mixed Multiple Autoimmune Syndrome Type 3 With Coexistence of Primary Biliary Cholangitis, Inflammatory Myopathy, and Chronic Thyroiditis: A Case Report

## TL;DR

This case report describes a rare instance of a 78-year-old woman with three overlapping autoimmune diseases and highlights the need for better screening and treatment protocols.

## Contribution

The novelty lies in documenting a rare case of mixed type 3 multiple autoimmune syndrome involving three specific autoimmune conditions.

## Key findings

- The patient had primary biliary cholangitis, inflammatory myopathy, and Hashimoto's disease.
- Treatment included corticosteroid pulses and azathioprine.
- Such mixed autoimmune syndrome cases are rare and require further study for effective management.

## Abstract

Multiple autoimmune syndromes (MAS) are a heterogeneous group of endocrine and non-endocrine autoimmune diseases. We present the case of a 78-year-old female with mixed type 3 MAS due to the presence of primary biliary cholangitis (PBC) and idiopathic inflammatory myopathy (IIM) with hypothyroidism due to Hashimoto's disease (HD), who was treated with corticosteroid pulses and azathioprine. Mixed MAS cases are rare, which implies the need for further studies to establish protocols for subclinical screening and management of simultaneous autoimmune pathologies with varying degrees of severity.