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Information

Editors

TomPettersson

Mixed Connective Tissue Disease (Mctd)

Definition and epidemiology

  • Mixed connective tissue disease (MCTD) is a rare disorder, that shows features of rheumatoid arthritis, SLE, polymyositis and systemic sclerosis and that is characterized by anti-ribonucleoprotein antibodies in high titre.
  • The clinical picture is variable and changes over time, often towards the clinical picture of systemic sclerosis.
  • Most patients are women aged 30-40 years.

Clinical picture

  • Almost all patients have arthritis or arthralgia
  • Swelling of the fingers and Raynaud's phenomenon
  • Skin changes resembling those seen in SLE
  • Muscle symptoms, which resemble those seen in polymyositis
  • Pleuritis, carditis and nephritis occur but are more common in SLE

Examinations and diagnosis

  • Full blood count, ESR, CRP, chemical urinalysis, plasma creatinine, creatine kinase, serum antinuclear antibodies, rheumatoid factor
  • Anaemia, leucopenia and thrombocytopenia are common findings.
  • ESR is usually elevated, but CRP concentration may be normal or slightly elevated.
  • Speckled pattern of anti-nuclear antibodies is a typical finding
  • Within specialized care e.g. determination of antibodies against extractable nuclear antigens: antibodies reacting with nuclear ribonucleoprotein are found. The diagnosis is made within specialized care.

Treatment