Mixed connective tissue disease(MCTD): Symptoms, Diagnosis, Complications & Treatments

Symptoms
MCTD is a disease that affects women aged 10 to 20, and it is common to have non-specific symptoms such as fatigue, myalgia, and arthralgia at first. In the end, however, there are characteristic symptoms, which differ from other connective tissue disorders as follows. First, the Raynaud phenomenon, swollen hand, and puffy finger are characteristic, and ANA shows a high tilter speckled pattern. In addition, kidney and central nervous system involvement is not often, and arthritis is a serious aspect. Unlike SLE and scleroderma, MCTD is a common symptom of pulmonary arterial hypertension.

Diagnosis
The anti-U1 RNP antibody is indispensable for the diagnosis of MCTD. However, this antibody is not unconditionally diagnosed. First, a positive ANA is suspected to be an early MCTD, followed by an anti-U1 RNP antibody. MCTD has a characteristic overlapping feature that tends to appear over a period of several years, and there is no universally accepted diagnostic criterion.

Complications
Pulmonary hypertension, the most serious complication of MCTD, is important for rapid diagnosis and treatment. Echocardiography is a rapid diagnostic method with a threshold of pulmonary arterial systolic pressure of 36 mmHg and fast therapy. The drugs used for treatment are calcium channel blockers (eg nifedipine), endothelin receptor antagonists (eg bosentan), phosphodiesterase-5 inhibitors (eg sildenafil) , And prostacyclin. In addition, diuretics can be considered as a general treatment for RV volume overload.

Treatments
NSAIDs, antimalarials (eg, hydrochloroquine) prednisone, etc. are used for fatigue, myalgia, etc., which are the main symptom of the patient's complaint. However, prednisone alone is used in combination with other immunosuppressant drugs when symptoms can not be improved or when side effects are high. Azathioprine, methotrexate, and other drugs.

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