Information
Editors
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.