YOUR HEALTH
An illness that's a mixed bag
DR. DONOHUE

Correction: In the answer to the second question, "not all the important" should read "not all that important."

DEAR DR. DONOHUE: I was diagnosed with mixed connective tissue disease more than 10 years ago. I have been trying, through the years, to get information about it, without much luck. The majority of doctors and nurses don't know much about it. Could you please furnish me with some information? -- D.W.

ANSWER: Connective tissues compose the body's frame, scaffolding and packing material. They include bones, joints, cartilage, ligaments, tendons, fat and blood-vessel walls. There are five connective tissue diseases: rheumatoid arthritis, lupus, polymyositis (muscle inflammation), dermatomyositis (skin and muscle inflammation) and scleroderma (hard skin). In all of these, collagen -- a protein common to connective tissues -- is somehow involved.

Mixed connective tissue disease features a combination of the symptoms of the other connective tissue diseases, especially lupus, scleroderma and polymyositis. The symptoms of one of those connective tissue disorders might follow the symptoms of a different disorder, or symptoms of different connective tissue disorders might be present together. A common combination includes swollen hands, arthritis, painful muscles and tight skin over the fingers. Raynaud's phenomenon is usually present. It's an exaggerated response of the hands (and sometimes the feet) to cold. On exposure to cold, hand arteries constrict inordinately and for so long that the blood supply to the hands and fingers stops. That brings on pain and a change of skin color from white to blue and then to red when blood flow resumes.

A peculiar blood antibody - - anti-U1-RNP -- helps confirm the diagnosis.

A nonsteroidal anti-inflammatory medicine like Indocin is often the initial treatment. Quite often, prednisone -- one of the cortisone drugs -- has to be prescribed. The choice of medicine depends on which connective disease symptoms predominate.

At least half of mixed connective disease patients have a favorable course. One complication of the illness is a rise of lung blood pressure -- pulmonary hypertension. There are medicines for it, should it develop.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853-6475. Readers may also order health newsletters from www.rbmamall.com. 2006 North America Syndicate Inc. All Rights Reserved