Positive RNP (MCTD)

MCTD is a classification category, like all 'diagnoses', meaning doctors have decided what they are going to call SLE or UCTD or MCTD etc. Not everybody fits into a neat classification box !
anti RNP is quite common in a number of autoimmune connective tissue diseases. It is very high levels that are usually a classification criteria for MCTD plus symptoms such as Raynaud's and sausage fingers and, classically, features of SLE, dermato/myositis and sceleroderma. Sometimes one might predominate or come to predominate.

In fact the nature of the disease you have, is the symptoms you are suffering. If the doctor thinks another CTD diagnosis is more appropriate than RA in any individual case he might want to change the treatment. Humira Enbrel and Remicaide aren't use much in SLE etc unless there's a strong RA component and no existing anti ds DNA, because they can cause anti ds DNA antibodies to occur. Or a doctor might want to add a disease modifying drug such as Plaquenil more often used in SLE and Sjogren's

It all depends on symptoms - what the patient reports, and signs - what the doctor observes. If your symptoms are not improved either, the appearance of the anti RNP or the rise in ANA might be seen as a need for more effective medication.
I thought RA was characterised by swollen joints ( and joint deformity) but it's possible I am quite wrong.
Of course, it's very bad from the insurance point of view to get an SLE diagnosis. In your place I'd be more concerned I was getting optimal treatment than what my condition might be called.

HTH
BB

Jeannie,

I have MCTD which by definition is lupus, scleroderma and PM.  By their very nature AI diseases are very elusive and difficult to understand, diagnose and treat.  It is possible that you have had MCTD all along but it is also possible that your immune system has had new disruptions and your disease has morphed into a connective tissue disease.

It is not likely that you are getting false positives from your labs since you have already been diagnosed with lupus, RA and Sjogrens.  Secondary conditions like Raynuads and Gerds are common.

Do you have any muscle weakness?  Difficulty getting out of chairs, going up stairs, raising your hands over your head, or even swallowing? 

Most patients with MCTD exhibit some symptoms of myositis like I just described.  GERDs can be caused by myositis by weakening the spincter muscles at the top of the stomach.

MCTD is considered a separate disease that can have symptoms of all 3 diseases.  Every case is different and the range of severity is from mild to very severe like my case.  There has been a debate since 1972 over whether MCTD is a separate disease or not but it takes the presence of anti U1 RNP antibodies to make a diagnosis.  I had symptoms of lupus and polymyositis and possible internal scleroderma but that was never determined for sure even after several endoscopic exams and many biopsies.  I had severe joint pains for the first 5 months until prednisone relieved those pains.  Those symptoms could have been diagnosed as some form of arthritis by a less experienced doctor.

http://www.emedicine.com/med/topic3417.htm

Hope you can get answers but the treatment for MCTD is similar to lupus and myositis (except IBM) diseases.  Do not ignore any increase in muscle weakness or swallowing problems as these symptoms are indicative of an active disease state and the need for a change of meds.

Bill

 

Hello Trying2bfree

So much good information was given to you in all of these posts.  the things that people said to you also helped me.  I didn't know that we needed to ignore muscle weakness.  After I say such things to my doctor and he does not speak to the symptom, I let it drop, thinking that this isn't something they need to know.

Thank you Bill for sending this website, and the info there.

Hope things will be better for you Trying2bfree.  this is what all of us are doing aren't we?  Trying to be free of disease, trying to be free of symptoms.  It is a good name that you gave to yourself.

Hester

Hey Kwicker

Yes I have been examined for this and was diagnosed to be fibromyalgia.  but this doctor died.  He also diagnosed me for lupus.  the first blood test that I had taken for Lupus was done at the same time.  but the doctors I have now do not agree with Dr. Marlowe. 

I never had the face rash myself.  Red faced but not the butterfly rash.  But I have enough of the other symptoms to have a diagnoses of Lupus.  I wonder why Rheumatoloigist choose to not diagnose for Lupus.  they go out of their way to find some reason to diagnose that we have Lupus.  Even when he hears me say these symptoms that I have, he will still find a way to eliminate the diagnoses of Lupus.

I also apologize for being so long to post again to our group.  Just had some really awful depression, and that together with the pain, the nausea, the loss of energy and strength, and motivation, was getting through the day was hard.

but good days arrived again.  two wonderful days of pain free, and mentally capable, and then the pain started again.  I still have the mental capacity however.  I will try to do better posting than I have been doing.

Hester