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Autoimmune diseases (ADs) are chronic conditions initiated by the loss of immunological tolerance to self-antigens and represent a heterogeneous group of disorders that affect specific target organs or multiple organ systems. The chronic nature of these diseases places a significant burden on the utilization of medical care, direct and indirect economic costs, and quality of life.

The mosaic of autoimmunity describes the multi-factorial origin and diversity of AD expression (1). This term implies that different combinations of many factors involved in autoimmunity produce several distinct clinical presentations that represent the wide spectrum of AD. The term “kaleidoscope of autoimmunity” portrays the possible change from one disease to another or the fact that more than one disease may coexist in the same individual or family (2). The fact that ADs share several clinical signs and symptoms (ie subphenotypes …