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Immunologic reactivity as a possible cause of disease (immune-mediated tissue injury) was recognized only at the turn of the 20th century. At that time, Ehrlich first introduced the term "horror autotoxicus," and the tuberculin reaction, anaphylaxis, and allergy were described. The first report on an autoimmune disease, paroxysmal cold hemoglobinuria, was published by Julius Donath and Karl Landsteiner in 1904. But it was not until the second half of the 20th century that research on the detection and analysis of autoantibodies provided useful new possibilities in the diagnosis of autoimmune diseases and that the improved understanding of tolerance and T-cell
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