mixed connective tissue disease
Introduction
Introduction to mixed connective tissue disease Mixed connective tissue disease (MCTD) is a type of overlap syndrome found in recent years, which has similar performance to other collagen diseases such as systemic lupus erythematosus, dermatomyositis and systemic sclerosis, but with three Any one of them is not completely consistent and cannot be attributed to any syndrome of collagen disease, and is therefore called mixed connective tissue disease. The disease has very little renal damage in the clinic, but it has high titers of anti-RNP antibodies in immunological serum, and the hormone treatment effect is good. basic knowledge The proportion of illness: 0.03% Susceptible people: good for women around 30 years old Mode of infection: non-infectious Complications: pleurisy Myocarditis Mitral insufficiency Aortic insufficiency Epilepsy Dysphagia Headache Sjogren's syndrome
Cause
Mixed connective tissue disease etiology
Genetic (35%):
Family analysis showed that all patients with human leukocyte antigen-B8 (HLA-B8) were prone to mixed collagen disease, and their inhibitory T lymphocytes (T8 cells) were inferior. Some people think that B8 may be an immune response disorder. Sign. Inhibitory T lymphocytes are involved in the control of immune response genes. When T lymphocyte function is low, the immune response genes are out of control, resulting in immune disorders in vivo (humoral immunity and cellular immune disorders).
Virus infection (25%):
(1) The cytotoxic effect of virus-infected T cells is enhanced, resulting in destruction of tissue cells, and the function of virus-infected T cells is inhibited, resulting in enhanced B cells producing antibodies.
(2) host endogenous infection or endogenous viral products, through the homologous effect of the virus on the HLA-B8 positive host, the virus can be planted on the surface of white blood cells, thus the emergence of anti-viral and anti-viral infection cell reactions, these The response includes cellular immune responses and humoral immune responses. The virus can change the tissue components and produce autoantigenicity, stimulate the B cells to produce corresponding antibodies, react with antigens and antibodies, form immune complexes, and cause tissue damage.
Prevention
Mixed connective tissue disease prevention
(1) The cause of MCTD is related to the autoimmune dysfunction. Therefore, it is necessary to strengthen physical exercise, have a reasonable life law, and maintain a happy mood to improve the body's immune function.
(2) Strengthen nutrition, supplement vitamins, and avoid and reduce the side effects of hormones, immunosuppressive agents, and non-steroidal drugs.
(3) Pay attention to keep warm and avoid being affected by the cold.
Complication
Mixed connective tissue disease complications Complications pleurisy myocarditis mitral insufficiency aortic valve insufficiency epilepsy dysphagia headache dry syndrome
About one-third of patients have fever, and 6% to 7% of patients are associated with Sjogren's syndrome and chronic lymphatic thyroiditis. Occasionally, swollen lymph nodes, connective tissue diseases can cause multiple organ damage, such as arthritis, can cause swelling and pain in joint tissues, often accompanied by key activity disorders. At the same time, patients may have obvious fever and bacterial infections. Blood routine white blood cells are often significantly increased, and severe cases can lead to sepsis.
Symptom
Mixed connective tissue disease symptoms Common symptoms Powerless papules Discoid erythema Dyspnea Dysphagia Lymph node enlargement Joint malformation pale reticular leukoplakia
Typical clinical manifestations are Raynaud's phenomenon, polyarthritis or multiple joint pain, diffuse swelling of the hands and fingers or conical thinning of the fingers or appearance of the sausage, low esophageal motility and multiple myalgia, lung lesions The onset of this disease is very varied. Most of them have the Raynaud phenomenon as the earliest manifestation, but there are also muscle pain and tenderness accompanied by muscle weakness. Some patients have fever and polyarthritis as early complaints. The patients were characterized by erythematous skin lesions, fever, myocarditis, arrhythmia, and generalized lymphadenopathy.
Examine
Mixed connective tissue disease examination
1. Blood routine and erythrocyte sedimentation rate: White blood cells are generally normal or decreased. If infected, white blood cells can be elevated. Red blood cells may have a mild or moderate decrease, and platelets may also reduce the erythrocyte sedimentation rate when the disease is active.
2. Urine routine: Some patients have a small amount of proteinuria, red blood cells, and sometimes tube type.
3. Biochemical examination: Serum muscle enzymes (alanine aminotransferase, aspartate aminotransferase, creatine phosphokinase, aldolase, lactate dehydrogenase) are elevated when muscle is involved, and gamma globulin is elevated by protein electrophoresis in 3/4 patients.
Diagnosis
Diagnosis and diagnosis of mixed connective tissue disease
The disease is similar to systemic lupus erythematosus, dermatomyositis, systemic sclerosis, so it should be noted that the above diseases are identified. Can rely on clinical features and immunological specific examination, if necessary combined with histological pathological changes, generally not difficult to identify. The identification of overlapping syndromes associated with systemic lupus erythematosus by clinical symptoms alone is quite difficult.
