Undifferentiated connective tissue

It has been shown that lung macrophages from patients with systemic sclerosis (SS) produced the elevated levels of nitric oxide, superoxide, and peroxynitrite and expressed the enhanced level of iNOS [281], NAC administration reduced peroxynitrite production and might be possibly recommended for the treatment SS patients. Solans et al. [282] found the significant enhancement of lipid peroxidation in erythrocytes from SS patients. Cracowski et al. [283] showed that in vivo lipid peroxidation was enhanced in scleroderma spectrum disorders including SS and undifferentiated connective tissue disease. 

Several epidemiologic studies of scleroderma, undifferentiated connective tissue disease, and multiple sclerosis suggest modest associations with any solvents or with organic or chlorinated solvents Trichloroethylene, paint removers, and mineral spirits are some of the specific solvents implicated in these studies. Mechanistic research in MRL +/+ lupus mice. 

Lacey, J.V., et al., Petroleum distillate solvents as risk factors for undifferentiated connective tissue disease (UCTD), Am. J. Epidemiol., 149, 761, 1999. 

An 84-year-old woman with polymyalgia rheumatica and a 79-year-old woman with undifferentiated connective tissue disease and leukocytoclastic vasculitis were given prednisolone 20 mg/day with subsequent dosage reductions. The first patient developed a raised purpuric rash and lymphedema of the left leg within 5 months and the second developed large purple nodules on the soles of her feet and the backs of her hands accompanied by periorbital and peripheral edema. Skin biopsies showed Kaposi s sarcoma, and both patients had raised IgG antibody titers to human herpesvirus-8. 

Although there are reports of associations between exposure to organic solvents and various connective tissue diseases, such as systemic sclerosis, scleroderma, undifferentiated connective tissue disease, systemic lupus erythematosus, and rheumatoid arthritis, the evidence of a causal association is weak (44). 

In an evaluation of the frequency and clinical characteristics of the underlying connective tissue disorders associated with silicone breast implants, 300 women with silicone breast implants were studied (45). In addition to a history and physical examination, C reactive protein, rheumatoid factor, and autoantibodies were determined. Criteria for fibromyalgia and/or chronic fatigue syndrome were met by 54% connective tissue diseases were detected in 11% and undifferentiated connective tissue disease or human adjuvant disease in 10.6%. A variety of disorders, such as angioedema, frozen shoulder, and a multiple sclerosis-like syndrome, were also found. Several other miscellaneous conditions, including recurrent and unexplained low grade fever, hair loss, skin rash, symptoms of the sicca sjmdrome, Rajmaud s phenomenon, carpal tunnel syndrome, memory loss, headaches, chest pain, and shortness of breath were also seen. Of 93 patients who underwent explantation, 70% reported improvement in their systemic symptoms. 

Undifferentiated connective tissue disease (UCTD) is a term used to describe conditions where people have symptoms and laboratory test results that resemble known musculoskeletal diseases such as SS and SSc, but do not have enough of the symptoms to meet the requirement for a well-defined diagnosis of a single disease. A study of patients with UCTD found statistically significant associations with exposures to paint thinners and paint removers.1311... 

Laing T], Schottenfeld D, Lacey JV Jr, et al Potential risk factors for undifferentiated connective tissue disease among women implanted medical devices. Am J Epidemiol 154 610-617, 2001... 

Connective tissne-associated DPLD Rheumatoid arthritis Systemic sclerosis Systemic lupus erythematosus Polymyositis/dennatomyositis Mised coimective tissue disease Undifferentiated connective tissue disease... 

Kinder BW, Collard HR, Koth L, et al. Idiopathic nonspecific interstitial pneumonia lung manifestation of undifferentiated connective tissue disease Am J Respir Crit Care Med 2007 176 691-697. 

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