Polyautoimmunity is one of the major clinical characteristics of autoimmune diseases (ADs). The aim of this study was to investigate the prevalence of ADs in spondyloarthropathies (SpAs) and vice versa. This was a two-phase cross-sectional study. First, we examined the presence of ADs in a cohort of patients with SpAs ( ). Second, we searched for the presence of SpAs in a well-defined group of patients with ADs ( ) including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and Sj？gren’s syndrome (SS). Among patients with SpAs, ankylosing spondylitis was observed in the majority of them (55.6%). There were two patients presenting with SS in the SpA group (1.4%) and 5 patients with autoimmune thyroiditis (3.5%). The global prevalence of ADs in SpAs was 4.86%. In the ADs group, there were 5 patients with SpAs (0.46%). Our results suggest a lack of association between SpAs and ADs. Accordingly, SpAs might correspond more to autoinflammatory diseases rather than to ADs. 1. Introduction Spondyloarthropathies (SpAs) are a group of interrelated diseases with joint inflammatory involvement such as arthritis (axial and peripheral) and extraarticular involvement such as uveitis, enthesitis, psoriasis, and inflammatory bowel disease (IBD). This group of diseases is characterized by familial aggregation, absence of rheumatoid factor, and association with human leukocyte antigen (HLA)-B27 [1]. Classically, SpAs have been classified as ankylosing spondylitis (AS), Reiter syndrome (RS), reactive arthritis (ReA), psoriatic arthritis (PsA), IBD-associated SpA, and forms called undifferentiated SpA (uSpA) that do not meet the criteria for previous categories [2]. However, currently, there is a new classification for SpAs. This new classification includes two types of SpAs: axial and peripheral SpA depending on the predominant spinal or peripheral involvement [3, 4] and extraarticular involvement such as anterior uveitis or IBD, which are also considered part of the SpA group [5]. Autoimmune diseases (ADs), in turn, are a clinical syndrome caused by the loss of immune tolerance and characterized by T- or B-cell activation leading to tissue damage in the absence of any other evident cause [6]. Criteria for AD definition have been described and revisited [7]. These criteria, which include direct and indirect proof as well as circumstantial evidence [6], are described in Table 1. However, in many diseases labeled as autoimmune, there are several limitations to fulfill the concept of autoimmunity, which are mainly related to the lack of direct proof
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