Mixed Connective Tissue Disease

MCTD usually has features of 3 main diseases: SLE, myositis and scleroderma, depicted by the recipe. The manifestation of the three diseases though rarely all present at the same time. Patients with MCTD have high titer anti-U1 ribonucleoprotein (RNP) - depicted in the right lower quadrant - it is the major ingredient! The rest of the images depict the 5 criteria from the Alarcon-Segovia's diagnostic criteria. For diagnosis you need 3 of the 5 clinical criteria, and the anti-U1 RNP at a titer of >1:1600. Kahn's criteria is similar but does not include acrosclerosis. Although this depicts one of the diagnostic criteria, it is not universally accepted. Patients with MCTD are at high risk of pulmonary hypertension.