Sequential appearance of ankylosing spondylitis, retroperitoneal fibrosis and achalasia: Coincidental association or evidence of autoimmunity?

SUMMARY The association of idiopathic achalasia with ankylosing spondylitis and retroperitoneal fibrosis, to our knowledge not previously reported, is described in a 54 year old woman. We suggest that the consecutive occurrence of ankylosing spondylitis and retroperitoneal fibrosis, two well-known autoimmune disorders, before the presence of achalasia, reinforces the theory of autoimmunity in etiopathogenesis of achalasia.