Mixed Connective Tissue Disease Evolving from the Sequential Overlap of Systemic Lupus Erythematosus, Sjögren’s Syndrome, Rheumatoid Arthritis, and Dermatomyositis: A Follow-Up

    May 2025 in “ The Journal of Rheumatology ”
    Jing Cheng, Darwin Ang, Ann‐Lii Cheng, Elaine Tan, Evan S. Vista
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    TLDR Mixed Connective Tissue Disease can develop from overlapping symptoms of several autoimmune diseases, making diagnosis complex.
    This case report describes a 32-year-old Filipino female with Mixed Connective Tissue Disease (MCTD), characterized by the sequential development of Systemic Lupus Erythematosus (SLE), Sjögren’s Syndrome, Rheumatoid Arthritis, and Amyopathic Dermatomyositis over seven years. Initial symptoms included fever, alopecia, and arthritis, with serological markers confirming SLE. She later developed symptoms consistent with Sjögren’s Syndrome and Rheumatoid Arthritis, followed by dermatological signs of Amyopathic Dermatomyositis. The presence of high-titer Anti-U1 RNP antibodies was noted, which is a hallmark of MCTD. The case highlights the complexity of diagnosing MCTD due to its overlapping features and emphasizes the importance of monitoring for complications like interstitial lung disease. Treatment included corticosteroids, DMARDs, and nintedanib to manage symptoms and reduce future disease risks.
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