MCTD

Question 1

Define MCTD.

Answer 1

• rheumatic disease syndrome characterised by overlapping clinical features similar to those of SLE, scleroderma, and polymyositis/dermatomyositis.
• The characteristic laboratory manifestations is a very increased titre of ANA to a nuclear ribonucleoprotein (RNP) antigen.

Question 2

Describe the typical sufferer of MCTD.

Answer 2

• F»M, 5-80yo (mean 37yo)

Question 3

Discuss the pathology encountered in MCTD.

Answer 3

Skin: 
•	scleroderma – like changes
•	 heliotrope rash of eyelids
•	 diffuse (non-scarring) alopecia
•	 telangiectasia
•	 lupus like rashes

Joints:
• arthritis (can be erosive and deforming

Muscles:
• inflammatory infiltrates
• degeneration of muscle fibres (myopathy)

Question 4

List five (5) typical clinical manifestations of MCTD.

Answer 4

• arthritis suggestive of RA (90%)
• swollen, puffy hands, with skin changes suggestive of scleroderma (90%)
• Raynaud’s phenomenon (90%)
• anaemia and leucopoenia (50%)
• disorders oesophageal motility (50% - 80%)
• lymphadenopathy (25%)