Mixed Connective-Tissue Disease (MCTD) Treatment & Management

Updated: Jan 21, 2021
  • Author: Eric L Greidinger, MD; Chief Editor: Herbert S Diamond, MD  more...
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Treatment

Approach Considerations

The overall goals of therapy for mixed connective-tissue disease (MCTD) are to control symptoms, to maintain function, and to reduce the risk of future disease consequences. Medical therapy targets control of disease activity in general and management of specific organ involvement (see Medication), while monitoring for and mitigating the risks of complications either of the condition itself (eg, pulmonary hypertension, interstitial lung disease) or of its treatment (eg, infection) (see Follow-up).

 

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Consultations

Whenever possible, a rheumatologist experienced in diagnosis and treatment of the disease should co-manage all patients with mixed connective-tissue disease (MCTD). Consultation with other specialists or subspecialists may be indicated for the evaluation and/or treatment of specific aspects of disease, such as pulmonary hypertension, interstitial lung disease, gastroesophageal reflux, or acute ischemia due to Raynaud's phenomenon.

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Diet and Activity

Aggressive cold avoidance may help to reduce the risk of flares of Raynaud's Phenomenon.

Patients with hypertension, esophageal reflux, malabsorption, or other sclerodermatous-type bowel involvement may need special consideration.

Because atherosclerotic heart disease remains a major risk in all patients, advocate a heart-healthy diet. However, no specific dietary manipulations have been demonstrated to be effective in treating MCTD.

Convincing data support the value of an active lifestyle and an exercise program tailored to the needs of patients with arthritis of various types. This approach also appears to be appropriate in MCTD.

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Prevention

Based on reports that other inflammatory rheumatic diseaes including rhuematoid arthritis, lupus, and slceroderma are independent risk factors for the development of atherosclerosis and related conditions, MCTD patients may also be at increased risk for atherosclerosis. As in these other conditions (and modeled after recommendations developed in diabetes mellitus), seeking to maintain more aggressive targets for blood pressure and cholesterol control may be appropriate.

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