       Document 0905
 DOCN  M9650905
 TI    Overlapping syndromes, undifferentiated connective tissue disease, and
       other fibrosing conditions.
 DT    9605
 AU    Kallenberg CG; University Hospital Groningen, Department of Clinical
       Immunology,; The Netherlands.
 SO    Curr Opin Rheumatol. 1995 Nov;7(6):568-73. Unique Identifier : AIDSLINE
       MED/96163724
 AB    Connective tissue diseases (CTDs) frequently present with one or only a
       few symptoms, which does not allow prompt diagnosis. Raynaud's
       phenomenon is one of those symptoms. However, only a minority of
       patients who present with Raynaud's phenomenon develop a CTD. Prognostic
       factors for the future development of CTD in such patients are older age
       at presentation, more severe Raynaud's phenomenon, the presence of
       antinuclear antibodies, and abnormal patterns on nailfold capillary
       microscopy. Some patients have overlapping symptoms of various CTDs.
       Mixed connective tissue disease (MCTD) is the prototype of such an
       overlapping syndrome. However, during follow-up, most patients with MCTD
       develop a specific CTD, either scleroderma, systemic lupus
       erythematosus, rheumatoid arthritis, or combinations of those illnesses.
       Primary pulmonary hypertension is one of the leading causes of death in
       MCTD. Its treatment is insufficient, although continuous prostacyclin
       infusion may provide some relief. New therapies such as nitric oxide and
       combined heart-lung transplantation in an early stage should be
       explored. The autoimmune response to small nuclear ribonucleoproteins,
       which is highly characteristic for MCTD, interestingly shows
       cross-reactivity with retroviral antigens, and the cooccurrence of human
       T cell lymphotropic virus type I and HIV infection with MCTD has been
       reported. This suggests that those viruses, possibly by molecular
       mimicry, play a role in the induction of the disease. Fibrotic
       conditions related to silicone exposure still evoke much interest.
       However, most recent data do not substantiate a role for silicone gel
       breast implants in the development of autoimmune CTDs.
 DE    Connective Tissue Diseases/*DIAGNOSIS  Diagnosis, Differential
       Fibrosis/DIAGNOSIS  Human  Raynaud's Disease/*DIAGNOSIS  Rheumatic
       Diseases/*DIAGNOSIS  JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

