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- $Unique_ID{BRK04006}
- $Pretitle{}
- $Title{Mixed Connective Tissue Disease (MCTD)}
- $Subject{Mixed Connective Tissue Disease (MCTD) Connective Tissue Disease
- MCTD}
- $Volume{}
- $Log{}
-
- Copyright (C) 1987, 1989 National Organization for Rare Disorders, Inc.
-
- 338:
- Mixed Connective Tissue Disease (MCTD)
-
- ** IMPORTANT **
- It is possible the main title of the article (Mixed Connective Tissue
- Disease) is not the name you expected. Please check the SYNONYMS listing to
- find the alternate names and disorder subdivisions covered by this article.
-
- Synonyms
-
- Connective Tissue Disease
- MCTD
-
- General Discussion
-
- ** REMINDER **
- The information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
-
- Mixed Connective Tissue Disease is a collagen disorder. MCTD is often
- used to describe what may be an overlapping group of connective tissue
- disorders that cannot be diagnosed in more specific terms. The syndrome is
- characterized by arthritic, cardiac, pulmonary and skin manifestations,
- kidney disease, muscle weakness, and dysfunction of the esophagus.
-
- Symptoms
-
- Raynaud's Phenomenon may precede disease manifestations by months or years,
- and is consists of coldness or numbness of the fingers and/or toes.
- Raynaud's occurs in approximately eighty-five percent of patients with MCTD.
- (For more information on this disorder, choose "Raynaud" as your search term
- in the Rare Disease Database). Pain in multiple joints (polyarthralgia) or
- arthritis similar to rheumatoid arthritis, occurs in almost all patients.
- Muscle weakness due to inflammation (myopathy) with or without tenderness is
- also common.
-
- Puffiness of the hands with swelling (edema) and increased collagen
- content in the skin (found in two-thirds of patients with MCTD), may be also
- be present. Other frequent skin findings include lupus-like rashes
- (including reddish brown patches), erythematous patches (redness) over the
- knuckles, violet discoloration of the eyelids, non-scarring loss of hair
- (alopecia), and dilation of small blood vessels around the fingernails
- (periungual telangiectasia).
-
- Dysfunction of the esophagus (hypomotility) may be found in eighty
- percent of patients with MCTD, including many who show no other symptoms.
- Abnormalities in lung function have been found in eighty percent of patients
- tested. In some patients, lung involvement may lead to breathing
- difficulties.
-
- Heart involvement appears to be less common in MCTD than lung problems.
- However, two-thirds of children in one pediatric study had evidence of
- pericarditis, myocarditis and aortic insufficiency.
-
- Kidney disease occurs in only ten percent of patients with MCTD and is
- often mild. On occasion, however, it can become a major problem.
-
- Neurologic abnormalities are noted in only ten percent of patients with
- MCTD. These findings may include a functional disturbance of facial
- sensation due to involvement of the fifth cranial nerve (trigeminal sensory
- neuropathy), a cognitive disorder caused by or associated with impaired brain
- tissue function (organic mental syndrome), blood vessel constriction causing
- "vascular" headaches, a mild form of meningitis (aseptic meningitis),
- seizures, blockage of a cerebral vessel (cerebral thrombosis) or hemorrhage,
- and various sensory disturbances in multiple areas of the body (multiple
- peripheral neuropathies).
-
- Moderate anemia and a reduction in the white blood cell count
- (leukopenia) occur in thirty to forty percent of cases. Fever, disease of
- the lymph nodes (lymphadenopathy), enlargement of the spleen (splenomegaly),
- enlargement of the liver (hepatomegaly), and intestinal involvement may also
- occur in a few cases.
-
- MCTD may be similar to, or overlap with systemic lupus erythematosus
- (SLE), scleroderma, progressive systemic sclerosis (PSS) and polymyositis.
- For more information on the above disorders, choose the following words as
- your search terms in the Rare Disease Database: Lupus, Scleroderma, PSS, or
- Polymyositis.
-
- Causes
-
- The exact cause of Mixed Connective Tissue Disease is unknown, although
- certain findings suggest that a dysfunction of the immune system may be
- involved, or in some cases it may be genetic. MCTD appears to be an
- autoimmune disorder. Autoimmune syndromes are caused by the body's natural
- defenses (antibodies) against invading organisms which, for unknown reasons,
- begin to attack healthy tissue.
-
- Affected Population
-
- Onset of Mixed Connective Tissue Disease can occur from four years of age to
- eighty years. Average age of onset is thirty seven-years. Approximately
- eighty percent of patients are female. The disease may occur worldwide.
-
- Related Disorders
-
- Systemic Lupus erythematosus (SLE) is an inflammatory connective tissue
- disease that can affect many parts of the body including the joints, skin and
- internal organs. Lupus is a disease of the body's immune system, most often
- striking young women between the ages of fifteen and thirty five years.
-
- Scleroderma, also known as progressive systemic sclerosis, refers to a
- group of chronic connective tissue disorders characterized by fibrosis,
- degenerative changes, and vascular abnormalities in the skin. Scleroderma is
- characterized by chronic hardening and shrinking of the connective tissues of
- any part of the body, although the term literally means "hardening of the
- skin."
-
- Polymyositis is a connective tissue disease characterized by inflammatory
- and degenerative changes in the muscles with some degree of muscle atrophy.
-
- For more information on the above disorders, choose "Lupus,"
- "Scleroderma," and "Polymyositis" as your search terms in the Rare Disease
- Database.
-
- Therapies: Standard
-
- Although no controlled studies have been performed, many of the
- manifestations of MCTD appear to respond to therapy with corticosteroids.
- Mild forms of the disease appear to be controlled by nonsteroidal anti-
- inflammatory drugs or low doses of corticosteroids. When more severe
- involvement of major organs occurs, larger doses of corticosteroids may be of
- benefit. This drug treatment also seems to improve skin symptoms and
- functioning of the esophagus and lungs.
-
- Therapies: Investigational
-
- Research into connective tissue diseases is ongoing. The primary goal at
- this time is to understand the cause. Discovery of the mechanisms which
- cause this group of diseases would be a major step forward in discovering
- better treatment or a cure.
-
- This disease entry is based upon medical information available through
- March 1987. Since NORD's resources are limited, it is not possible to keep
- every entry in the Rare Disease Database completely current and accurate.
- Please check with the agencies listed in the Resources section for the most
- current information about this disorder.
-
- Resources
-
- For more information on Mixed Connective Tissue Disease, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- Coalition of Heritable Disorders of Connective Tissue
- c/o National Marfan Foundation
- 382 Main St.
- Port Washington, NY 11050
- (516) 944-5412
-
- Arthritis Foundation
- 1314 Spring Street NW
- Atlanta, GA 30309
- (404) 872-7100
-
- Scleroderma Society
- 1725 York Ave., Suite 29F
- New York, NY 10128
-
- United Scleroderma Foundation
- P.O. Box 350
- Watsonville, CA 95077
- 1-800-722-HOPE (outside CA)
-
- Scleroderma Info Exchange
- 106 Quaker Drive
- West Warwick, RI 02893
-
- Sjogren's Foundation
- 29 Gateway Drive
- Great Neck, NY 11021
- (516) 487-2243
-
- National Lupus Foundation
- 5430 Van Nuys Blvd., Suite 206
- Van Nuys, CA 91401
-
- Lupus Foundation of America
- 1717 Massachusetts Ave. NW, Suite 20
- Washington, DC 20036
- (209) 328-4550
-
- Lupus Foundation of America Inc.
- P.O. Box 2446
- Victorville, CA 92393
-
- Systemic Lupus Erythematosus Foundation
- 149 Madison Ave., 10th Floor
- New York, NY 10016
-
- The National Arthritis and Musculoskeletal and Skin Diseases Information
- Clearinghouse
- Box AMS
- Bethesda, MD 20892
- (301) 495-4484
-
- References
-
- PRIMER ON THE RHEUMATIC DISEASES, 8th Ed: Gerald P. Rodnan, M.D., et. al.,
- eds.; Published by the Arthritis Foundation, Atlanta, GA 1986. Pp. 65-66.
-
-