MCTD

An overlap disease that has signs and symptoms of a combination of disorder such as lupus, polymyositis and scleroderma is called mixed connective tissue.

It is hard and complicated to diagnose this kind of disease because the separate disease does not appear all at once but tend to occur in sequence over a number of years. Hands are the first sign and symptoms of mixed connective tissue, the fingertips will become white and numb and the fingers will swell. Some organs such as heart, kidneys and lungs might be affected in later stages.

Because there is no cure for mixed connective tissue, the treatment for the signs and symptoms is medication like prednisone.

Some signs and symptoms of mixed connective tissue are:

• cold and numbness of fingers and toes also known as Raynaud’s phenomenon that occurs when your toes and fingers will turn white and become purplish blue then after warming the fingers and toes it will become red, this is due to stress and cold,
• general feeling of being unwell with increased mild fever and fatigue,
• joint and muscle pain, this is like rheumatoid arthritis when the joints are deformed,
• swollen fingers and hands where some people’s fingers are like sausages due to extreme swelling,
• there is a rash that is red or reddish brown patches that may appear over the knuckles.

If you are experiencing these signs and symptoms and you are bothered especially if you have been diagnosed with lupus or another connective tissue disease, visit your doctor to help you.

There is no known cause of mixed connective tissue.

Mixed connective tissue is an autoimmune disorder which means that our immune system that is responsible for fighting off disease mistakenly attacks healthy cells. The fibers that provide the framework and support for your body is attacked by your immune system.

One of the causes of mixed connective tissue might be the proteins produced by the immune system and researchers are still looking into it if it is true.

Some who has this disease has a family history but genetic is still not a clear cause of mixed connective tissue.

When you visit your doctor, he might recommend you to a rheumatologist that specializes in joint diseases to receive a diagnosis.

Here’s what you can do:

• Bring a notebook so that you can list all the things that you want to ask the doctor or things that he will tell you.
• Ask a family member or a close friend to accompany you in order for them to help you with relevant information and to support you.
• You can also list down the symptoms that you are experiencing and the medications, supplements or vitamins that you are taking every day.
• Write down the major stresses in your life or major changes.
• Ask your relatives if someone in your family had the same situation before.

Here are some of the questions that you can ask your doctor:

• What is causing my symptoms? Do I need tests?
• What tests do I need?
• Are there any treatments available?
• I have other health conditions, how can I manage them both? Is this long term?

Your doctor will likely ask you questions such as:

• What signs and symptoms are you experiencing?
• When did you first experience it?
• Are your symptoms continuous or occasional?
• How severe are they? Are they manageable?
• What, if anything improve or worsen your condition?

Your doctor will recommend that you do some tests such as:

• Physical examination to check for swollen hands and painful swollen joints,
• Blood test to determine if you have a certain antibody in your blood that is related to mixed connective tissue disease.

Mixed connective tissue disease has no cure and the treatment is based on managing the signs and symptoms with medications.

The medicines are only taken during flare-ups but if it is severe you may need a continuous medication.

Your doctor may give you medicines depending on the severity of your disease, these medications are:

• corticosteroids,
• antimalarial drugs,
• prednisone that suppresses inflammation and  prevents your immune system to attack healthy cells with side effects such as weight gain, mood swings, increased blood pressure, high blood sugar, cataracts and weakened bones,
• hydroxychloroquine or plaquenil that might prevent flare-ups and treat mild connective tissue,
• nifedipine (Procardia) and amlodipine (Norvasc) that may be used to treat Raynauds phenomenon and helps in relaxing your muscles in the walls of you blood vessel,
• calcium channel blockers and other immunosuppressant medicines.

Based on your specific signs and symptoms, your doctor may prescribed other medications like:

• pulmonary hypertension medications,
• if the symptoms is similar to lupus, he may prescribed medication typically for people with lupus,
• sildenafil (Ravatio Viagra) and bosentan (Tracleer) may also be prescribed.

Your doctor will look closely if you have signs of pulmonary hypertension.

There is no way of preventing the disease since the causes of mixed connective tissue disease are not known.

You can only prevent some of the symptoms of mixed connective tissue disease. Some of these are:

• enhance your nutrition and vitamin supplements to prevent and reduce the hormones and side effects of non-steroidal drugs,
• always keep warm and avoid cold,
• physical exercise to maintain a happy mood to improve immune function.

There are no alternative remedies for mixed connective tissue disease that have been proven effective.

You can have physical activities as well as change of diet to an anti inflammatory one can be helpful.

Lifestyle modifications are necessary in order to manage the symptoms of mixed connective tissue disease.

There are other ways to control the symptoms of mixed connective tissue disorder such as:

• medicines like ibuprofen (Advil, Mortin IB) and naproxen sodium (Aleve) that may relieve the inflammation and pain,
• nonsteroidal anti-inflammatory drugs,
• smoking cessation because it causes the blood vessels to narrow that can worsen the effects of Raynaud’s phenomenon,
• protecting hands from colds by wearing gloves and other measure to protect them from getting cold,
• reduce stress in your life to avoid Raynaud’s phenomenon,
• relaxation techniques such as breathing techniques to reduce your stress.

No matter what your age is, mixed connective tissue can occur to you but mostly it occurs to women under the age of 30 that might lead to serious complications such as:

• interstitial lung disease that can cause scarring in your lungs which can affect your ability to breathe,
• high blood pressure in the lungs also known as pulmonary hypertension that is the main cause of death of people who have mixed connective tissue,
• kidney damage that can lead to kidney failure and about ¼ of the people who have mixed connective tissue disease develop kidney problems,
• heart disease,
• inflammation around the heart may occur and some parts of the heart may become enlarged, and is the cause of death in 20 percent or people with mixed connective tissue,
• iron deficiency anemia in about 75 percent of the people with mixed connective tissue,
• digestive tract damage that occurs when you have problems with digesting food and may develop abdominal pain,
• necrosis or tissue death; gangrene in the fingers,
• hearing loss may occur in half of the people with mixed connective tissue,
• the side effects of the treatment of corticosteroids that people use, this is effective but have risks such as muscle weakness, infection and osteoporosis.

Your doctor may recommend the use of vitamin D and calcium supplements to adverse effects.