Autoimmune vs. Autoinflammatory What Category is HS in?

Updated: Jun 30

Both start with the prefix “auto” to define a pathological process directed against self. Both are characterized by activation of the immune system, seemingly without cause. There are not many diagnostic tools for autoinflammatory other than elevated inflammation markers such as high white blood cell count, C Reactive Protein, etc. Unlike autoimmune, where ANA and antineutrophil are typically present, these antibodies are not present in blood work with autoinflammatory illnesses (unless you have an autoimmune illness along with HS). The spectrum of autoinflammatory disorders continues to expand and some autoimmune illnesses are being reclassified to autoinflammatory or more newly classified as an immune-mediated inflammatory illness.


Autoinflammatory diseases or immune-mediated inflammatory illnesses cause systemic inflammation due to problems in the “innate immune system.” During an autoinflammatory or immune-mediated inflammatory illness flare constant inflammation seems to occur automatically or “on its own” (instead of in response to invading germs or infection) affecting joints, tissues, organs, every part of us. This auto-inflammation involves the nonspecific “innate immune system” and occurs periodically in some people or chronically (constantly). This can cause a disease flare with typical symptoms including fever, skin lesions, joint/muscle swelling and pain, body aches, gastrointestinal distress, overall malaise, and fatigue.


Autoimmune diseases involve the “acquired” or “adaptive” immune system, marked by the formation of antibodies that are mistakenly directed against specific parts of the body, leading the body to attack its own tissues as if it were fighting off invading pathogens. Both can show increased production of inflammatory cytokines (for example), however, auto-inflammatory illnesses (unlike classic autoimmune diseases) shows little to no evidence of specific adaptive immunity such as auto reactive T cells, lymphocytes and auto antibodies.

How is HS Classified?

There is no strong evidence or long-standing research supporting HS as an autoimmune disease and the past several years of research suggest HS as autoinflammatory affecting our innate immune system or or more newly classified as an immune-mediated inflammatory illness. Officially and technically it has not been classified as an autoimmune disease, but patients and doctors alike commonly use the “autoimmune” term as shorthand, which causes confusion and often leads to a debate between the two terms. “Autoimmune” has technical requirements medically that HS does not meet. Currently HS is considered an inflammatory follicle occlusion illness or more newly classified as an immune-mediated inflammatory illness.

Explore research on this topic HERE.

This is an awareness article for educational purposes only and is not intended to replace the advice of your doctor or other health care provider.

Written by Denise Panter-Fixsen

Edited by Brindley Kons

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