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© 1992 British Society for Rheumatology

other

MIXED CONNECTIVE TISSUE DISEASE—GOODBYE TO ALL THAT

C. BLACK and D. A. ISENBERG*,

Department of Rheumatology, Royal Free Hospital London
*Bloomsbury Rheumatology Unit, the Department of Rheumatology Research, University College and Middlesex Hospital School of Medicine London

Correspondence to: Correspondence to Dr D. Isenberg, Bloomsbury Rheumatology Unit, Arthur Stanley House, 40–50 Tottenham Street, London W1P 9PG

Since it was first described mixed connective tissue disease (MCTD) has been the subject of much debate. In particular the question of whether it is a truly distinctive disease entity has been challenged. It seems clear that the original description of MCTD as a mild disorder, rarely affecting the lungs or kidneys and requiring small doses of corticosteroids only, is no longer tenable. In this review a historical analysis of the clinical and serological features is presented. It is suggested that the concept of MCTD as a distinct disease entity is better replaced by the term ‘undifferentiated autoimmune rheumatic/connective tissue disorder’. Many of these patients will later ‘convert’ into scleroderma or lupus; some will remain undifferentiated.

KEY WORDS: Mixed connective tissue disease, Scleroderma, Serological features, Clinical features


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