Undifferentiated Connective Tissue Disease

Question: What is Undifferentiated Connective Tissue Disease in lamens terms? I'm going with my girl friend to the doctor and I want to ask some questions about this disease but dont' know what to ask?

Answer: It means that they know it is a connective tissue disease, but don't know which one because it isn't fitting all the criteria at this point. You might want to ask what will happen next in the course of the disease, about complications, etc. Looking up the different CTDs might give you more of an idea what to ask. "Many connective-tissue diseases (CTDs) share common signs and symptoms, which frequently makes the diagnosis of a specific rheumatic disease difficult. Rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), polymyositis (PM), dermatomyositis (DM), mixed connective-tissue disease (MCTD), and Sjögren syndrome (SS) can present with similar clinical features, particularly during the first 12 months of symptoms. Isolated Raynaud phenomenon, inflammatory polyarthritis, anemia, interstitial lung disease, or pleuropericarditis may occur without an obvious diagnosis. Screening serology findings, such as rheumatoid factor (RF) or antinuclear antibody (ANA), may be positive or negative under these clinical circumstances. However, well-established connective-tissue diseases have defined, discrete diagnostic criteria. Patients who present with symptoms, positive serology results, or physical findings consistent with an established connective-tissue disease but not fulfilling classification criteria for one of these established connective-tissue diseases are diagnosed with undifferentiated connective-tissue disease (UCTD). UCTD is a relatively new entity, suggested by LeRoy et al in 1980. The definition of UCTD is still under debate, although it is becoming more clear. Mosca et al recently reviewed UCTD literature and proposed that preliminary classification criteria include (1) signs and symptoms suggestive of a connective-tissue disease, (2) positive ANA results, and (3) a disease that lasts at least 3 years."

Question: Thyroid disease and now connective tissue disease as well, what's going on? I've had Hashimoto's thyroiditis for 4 years, now the doctor says I have an undifferentiated connective tissue disease as well. What could that turn out to be? Does this mean my immune system is getting worse? Can multiple auto-immune diseases be a result of stress or just bad luck? Or something else?

Answer: Those are two auto-immune diseases - where your immune system mistakenly attacks things in your body. Unfortunately, if you have one auto-immune disease, you are at a much higher risk of getting another one. They can tend to come in clusters. It doesn't mean your immune system is getting worse, it just means you are someone who is more likely to develop autoimmune disorders than other people.

Question: Once a person has a positive ANA titer, can they then have a negative ANA? I was taking prednisone by mouth when my ANA turned up negative. In the past years, I had positive ANAs with high titers of 1/2000 plus. I want to know if I might no longer have the "Undifferentiated Connective Tissue Disease" that I was diagnosed with in the past.

Answer: One in three healthy people has a positive ANA at a 1:40 dilution and one in twenty is still positive at 1:160. The antinuclear antibodies test should be interpreted along with other diagnostics and not by itself alone. My point is that you need to discuss this with your doctor who knows your history and can correctly interpret your titers and the fluorescence pattern.

Question: My white blood cells usually run 3.9 to 4.1 (female, age 26). Recently they were measured at 3.1.? How weak is my immune system? Is there medicine to boost the WBC count back up to where it should be? Does plaquinel help with this over time (I am on plaquinel for undifferentiated connective tissue disease).

Answer: I would ask a physician when it comes to white blood cell count. Especially when it drops!

Question: Dating and Lupus or RA? I have suffered with severe arthritis stemming from undifferentiated mixed connective tissue disease (sjogren's syndrome, fibromyalgia, and grave's disease have also been diagnosed) for 5 years. I need advice about dating. I'm just out of a long term relationship and although my ex swears my illness had nothing to do with our demise, I can't fight the feeling that it didn't help it out. Now I'm back out dating and the fatigue is taking its toll on me. I'm having a hard time juggling career, dating, and life in general. I know my bio clock is ticking and kids might be out of the question (at least conventionally). Any advice on how to manage? I hate the way this disease has taken over my life. I also hate having to start all over with dating. I want the real deal...I don't want to settle (that's why I"m currently single). Does anyone have any inspirational stories of life with RA or Lupus? I'm trying to stay positive. Please share....

Answer: My wife is the bravest person I know. She was diagnosed with Lupus at the age of 15. The doctors told her that her life expectancy would be ten years. Imagine being told that at fifteen. Last year she turned 28 and finished dental school. She is doing great. We are planning on having our first child next year and have been given the help and support we need by loving and caring doctors. Our life is wonderful, inspite of this terrible disease. She has her good days and her bad ones. Sometimes she can't walk up a flight of stairs or carry in the groceries but we look at eachother and laugh realizing that our kids will probably have to push us around in wheelchairs when we get older. I love her more than anything and she feels the same about me. I go to the doctors with her and share in her care. There is hope out there and you have to find someone who will be willing to take the journey with you. I'm not saying it's always easy, I have my down days too, but I wouldn't change a thing. She has made me a stronger man and I have been able to have the life that I only dreamed of. I wish you the best of luck. Don't give up hope you'll find someone out there who's willing to share life with you.

Question: Question about Methotrexate...? I have undifferentiated mixed connective tissue disease. I've tested positive for Sjogren's syndrome a few years back, but it is not primary. That means that I either have Lupus or Rheumatoid Arthritis. I've been taking plaquenil for 4+ years and had some toxicity. My dose has been decreased and I started taking Methotrexate in August. I currently take 10 mg. I've noticed minimal (very, very minor) improvement in joint swelling. I seem to have 2-3 good days a week, but still have considerable swelling in my joints. I see my rheumatologist in 3 weeks, but I thought I would ask anyone who is taking methotrexate to see how long it took them to know it is working. My major complaint is fatigue. I'm exhausted and I don't think the fatigue is worth the minimal improvement. If anyone who is currently taking this med can give me some advice, I would greatly appreciate it. Should I hang in there? I'm also doing homeopathic treatments with a doc and aqua therapy 2-3x a week.

Answer: I have systemic lupus. I have not taken methotrexate, but I did receive it intravenously in the hospital along with pulse steroids. I had bone marrow failure from the lupus and a very high sed rate, including pericarditis and other things. I too take plaquenil. I have been off prednisone for 6 months. I still take mycophenolate mofetil-Cellcept-for lupus kidney disease. It is hard to know whether it is the medication or the disease making you tired. Autoimmune mixed connective tissue diseases are extremely trick to manage. I would hang in there until you see your rheumy. Keep a journal of your activities and your symptoms. You may see some connections and this journal will be very useful to your rheumatologist. Please be sure to tell all your doctors and practitioners what the others are doing. If you have a good working relationship with your rheumatologist, you should be able to talk about your homeopathic and other complementary treatments with him or her. If you cannot talk this openly, get another doctor. The stress of the disease and its management are enough to bring on fatigue. Add to that the fact that the disease ITSELF causes fatigue and it is no wonder you feel that way. You did not get to your current level of inflammation overnight and it will not go down overnight. Are you on prednisone too? Did you have chloroquine retinopathy from the plaquenil? Feel free to email me at gazorpf@yahoo.com Best wishes. Be patient.