Akin, Vildan TuncbilekAltunan, BengüMercan, RıdvanÜnal, Aysun2024-10-292024-10-2920232147-9291https://doi.org/10.5336/caserep.2022-94634https://search.trdizin.gov.tr/tr/yayin/detay/1172881https://hdl.handle.net/20.500.11776/13886Autoimmunity reflects an altered immune status. The coexistence of three or more autoimmune diseases in a patient constitutes multiple autoimmune syndrome. Here, an interesting case with a history of Hashimoto’s thyroiditis and got the diagnosis of systemic lupus erythematosus during her evaluation, in which the clinical signs of neuromyelitis optica spectrum disorder (NMOSD) and miyasthenia gravis co- occurred will be discussed. In addition to high-dose pulse steroid, plasmapheresis and intravenous immunoglobulin treatments, rituximab treat- ment was started and the patient is followed up without clinical worsening and disability in the three-year follow-up. Patients with diagnosis of NMOSD need special attention as multiple immune-mediated disorders may be present simultaneously or sequentially during the course of the disease process. This case report emphasizes the importance of a multidisciplinary team approach for a better understanding of disorders related to the breakdown of immune tolerance.en10.5336/caserep.2022-94634info:eu-repo/semantics/openAccessAutoimmune diseasesHashimoto’s thyroiditisNeuromyelitis opticamiyasthenia gravissystemic lupus erythematosisArticle31156601172881