MIXED CONNECTIVE-TISSUE DISEASE - A SUBSET WITH SEQUENTIAL CLINICAL AND LABORATORY FEATURES

Abstract

Patients (23), who lacked the full picture of mixed connective tissue disease (MCTD) initially, developed new findings or experienced regression of initial features with time. Each patient had at least 1 extractable-nuclear-antigen (ENA) antibody titer .gtoreq. 1:10,000 composed exclusively of ribonucleoprotein but variation in titer occurred in 9 and Sm antibody was transiently found in 3 patients. Four initially had other diagnoses and negative antinuclear antibody (ANA) tests before developing speckled ANA. Eleven patients had consistently speckled ANA. As suggested by earlier clinical observations, MCTD can change clinically and serologically. This study demonstrates the sequential development of the features of SLE [systemic lupus erythematosus], polymyositis and rheumatoid arthritis, and emphasizes that serologic studies may also vary over time in these patients.