Undifferentiated Connective-Tissue Disease Treatment & Management

  • Author: Bernard Hildebrand, MD; Chief Editor: Herbert S Diamond, MD   more...
 
Updated: Jan 19, 2012
 

Medical Care

A patient with undifferentiated connective-tissue disease (UCTD) can be evaluated and treated primarily as an outpatient.

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Surgical Care

Surgery for patients with UCTD is not routinely necessary and should be initiated only when indicated for diagnosis or treatment.

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Consultations

  • A rheumatologist should be consulted.
  • Consultations with other specialists may be clinically indicated, including with a dermatologist, ophthalmologist, pulmonologist, cardiologist, neurologist, physical medicine specialist, physical therapist, and/or occupational therapist.
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Diet

No special diet is recommended for patients with UCTD.

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Activity

  • In general, activities are not restricted in the absence of specific functional limitations associated with UCTD.
  • Patients with photosensitivity should minimize prolonged exposure to sunlight and should use protective clothing and sunblock lotions/creams to protect against ultraviolet light.
  • Patients with severe Raynaud phenomenon should avoid prolonged exposure to severe cold temperatures (< 40° F) to avoid digital vasospasm. Layered clothing, hats, and gloves help to maintain a warm core body temperature and decreased vasospastic symptoms. Tobacco use should be avoided.
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Contributor Information and Disclosures
Author

Bernard Hildebrand, MD  Chief of Rheumatology, Mike O'Callaghan Federal Hospital, Nellis Air Force Base

Bernard Hildebrand, MD is a member of the following medical societies: American College of Physicians, American College of Rheumatology, and American Society for Bioethics and Humanities

Disclosure: Nothing to disclose.

Coauthor(s)

Daniel F Battafarano, DO, FACP, FACR  Clinical Professor of Medicine, University of Texas Health Science Center at San Antonio; Associate Professor of Medicine, Uniformed Services University of the Health Sciences, F Edward Hebert School of Medicine; Chief of Rheumatology Service, San Antonio Military Medical Center

Daniel F Battafarano, DO, FACP, FACR is a member of the following medical societies: American College of Physicians, American College of Rheumatology, and Association of Military Surgeons of the US

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Elliot Goldberg, MD  Dean of the Western Pennsylvania Clinical Campus, Professor, Department of Medicine, Temple University School of Medicine

Elliot Goldberg, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, and American College of Rheumatology

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Herbert S Diamond, MD  Adjunct Professor of Medicine, Division of Rheumatology, University of Pittsburgh School of Medicine; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital

Herbert S Diamond, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology, American Medical Association, and Phi Beta Kappa

Disclosure: Merck Ownership interest Other; Smith Kline Ownership interest Other; Zimmer Ownership interest Other

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Table 1. Preliminary Classification Criteria for Undifferentiated Connective-Tissue Disease
Inclusion CriteriaClinical



Exclusion Criteriaa



Laboratory Exclusion Criteriaa
1. Signs and symptoms suggestive of a CTD but not fulfilling the diagnostic or classification criteria for any of the defined CTDs b for at least 3 years c



2. Presence of antinuclear antibodies determined on two different occasions



Malar rash



Subacute cutaneous lupus



Discoid lupus



Cutaneous sclerosis



Heliotrope rash



Gottron papules



Erosive arthritis



Anti-dsDNA



Anti-Smith



Anti-U1-RNP



Anti-Scl70



Anticentromere



Anti-La/SSB



Anti-Jo1



Anti-Mi2



Table 2. Predictors of Progression to Definite Connective-Tissue Disease
Connective-Tissue Disease AssociationSigns or SymptomsLaboratory Data
Systemic lupus erythematosusAge, fever, photosensitivity, serositis, alopeciaANA, Anti-dsDNA, Anti-Smith, Anti-cardiolipin antibodies, Coombs positivity, leukopenia
Systemic sclerosisSclerodactyly, Raynaud phenomenon, sicca symptoms, esophageal dysfunctionANA with nucleolar pattern
Sjögren syndromeXerostomia, xerophthalmia, Raynaud phenomenonAnti-SSA, Anti-SSB
Rheumatoid arthritisSymmetric polyarthritisRF, elevated ESR (>70 mm/h)
Mixed connective-tissue diseaseEsophageal reflux, polyarthritis, Raynaud phenomenonANA, Anti-U1-RNP
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