"To Be or Not To Be, " Ten Years After : Evidence for Mixed Connective Tissue Disease as a Distinct Entity (CROSBI ID 177909)
Prilog u časopisu | izvorni znanstveni rad | međunarodna recenzija
Podaci o odgovornosti
Cappelli, S. ; Bellando Randone, S. ; Martinović, Dušanka ; Tamas, M.M. ; Pašalić, K. ; Allanore, Y. ; ... ; Radić, Mislav ; ... ; Matucci Cerinić, M.
engleski
"To Be or Not To Be, " Ten Years After : Evidence for Mixed Connective Tissue Disease as a Distinct Entity
Objectives were to determine if mixed connective tissue disease (MCTD) can be considered an independent clinical entity, to compare 3 different classification criteria for MCTD (Kasukawa, Alarcón-Segovia, and Sharp), and to define predictors (clinical features and autoantibodies) of potential evolution toward other connective tissue diseases (CTDs). One hundred sixty-one MCTD patients were evaluated retrospectively at the diagnosis and in 2008. They were classified, at the diagnosis, according to the 3 classification criteria of MCTD (Sharp, Alarcón-Segovia, and Kasukawa) and reclassified in 2008 according to their evolution. Statistical analyses were performed to find out predictors (clinical features and autoantibodies) of evolution into other CTDs. After a mean of 7.9 years of disease, 57.9% of patients still satisfied MCTD classification criteria of Kasukawa ; 17.3% evolved into systemic sclerosis, 9.1% into systemic lupus erythematosus, 2.5% into rheumatoid arthritis, 11.5% was reclassified as affected by undifferentiated connective tissue disease, and 1.7% as suffering from overlap syndrome. Kasukawa's criteria were more sensitive (75%) in comparison to those of Alarcón-Segovia (73%) and Sharp (42%). The presence of anti-DNA antibodies (P = 0.012) was associated with evolution into systemic lupus erythematosus ; hypomotility or dilation of esophagus (P < 0.001) ; and sclerodactyly (P = 0.034) with evolution into systemic sclerosis. MCTD is a distinct clinical entity but it is evident that a subgroup of patients may evolve into another CTD during disease progression. Initial clinical features and autoantibodies can be useful to predict disease evolution.
mixed connective tissue disease; distinct entity
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