The Achilles heel of the adaptive immune system is certainly the risk of mounting destructive and often durable immune responses directed toward self-antigens. As a testament to this risk, a broad array of distinct human autoimmune diseases has been defined, ranging from the tissue-specific to the systemic; these include well-recognized entities such as type I diabetes, multiple sclerosis, and systemic lupus erythematosus, and extend to diseases like myasthenia gravis and Graves' disease with highly specific and focused target antigens. In addition, the risk of triggering frank autoimmunity is a dark shadow that can trail otherwise protective immune responses to cancer neo-antigens in the form of paraneoplastic syndromes, and to infectious diseases via molecular mimicry (eg, rheumatic fever and Guillain-Barré syndrome). Most recently, release of latent auto-reactivity triggered by therapeutic checkpoint blockade has manifested in the form of occasionally severe immune-related adverse events (irAEs). Therefore, it should come