Kevin John John, Mohammad Sadiq, Tina George, Karthik Gunasekaran, Nirmal Francis, Ebenezer Rajadurai, Thambu David Sudarsanam
{"title":"Clinical and Immunological Profile of Mixed Connective Tissue Disease and a Comparison of Four Diagnostic Criteria.","authors":"Kevin John John, Mohammad Sadiq, Tina George, Karthik Gunasekaran, Nirmal Francis, Ebenezer Rajadurai, Thambu David Sudarsanam","doi":"10.1155/2020/9692030","DOIUrl":null,"url":null,"abstract":"<p><p>Mixed connective tissue disease (MCTD) was initially described as a chronic immune-mediated disease with overlapping features of systemic lupus erythematosus, scleroderma, and polymyositis. We conducted a cross-sectional study to describe the clinical and immunological profile of patients with MCTD and to compare the four diagnostic criteria, namely, Sharp, Kasukawa, Alarcón-Segovia, and Khan criteria. A total of 291 patients who were admitted from June 2007 to June 2017 and fulfilled the inclusion criteria were included in the study. A clinical diagnosis of MCTD was made in 111 patients, of whom 103 (92.8%) were women. The mean age at presentation was 39.3 years (SD ± 11.6). The most common organ systems that were involved were musculoskeletal system (95.5%), skin and mucosa (78.4%), and the gastrointestinal and hepatobiliary systems (56%). The maximum sensitivity was for the Kasukawa criteria with a sensitivity of 77.5% (95% CI 68.4-84.6) and specificity of 92.2% (95% CI 87-95.5). The Kahn criteria and Alarcón-Segovia criteria had the maximum specificity; the Alarcón-Segovia criteria had a sensitivity of 69.4% (95% CI 59.8-77.6) and a specificity of 99.4% (95% CI 96.5-99.9), while the Kahn criteria had a sensitivity of 52.3% (95% CI 42.6-61.7) and a specificity of 99.4% (95% CI 96.5-99.9). The sensitivity and specificity of Sharp criteria were 57.7% (95% CI 47.9-66.87) and 90% (95% CI 84.4-93.8), respectively.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2020-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9692030","citationCount":"33","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Rheumatology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2020/9692030","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2020/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 33
Abstract
Mixed connective tissue disease (MCTD) was initially described as a chronic immune-mediated disease with overlapping features of systemic lupus erythematosus, scleroderma, and polymyositis. We conducted a cross-sectional study to describe the clinical and immunological profile of patients with MCTD and to compare the four diagnostic criteria, namely, Sharp, Kasukawa, Alarcón-Segovia, and Khan criteria. A total of 291 patients who were admitted from June 2007 to June 2017 and fulfilled the inclusion criteria were included in the study. A clinical diagnosis of MCTD was made in 111 patients, of whom 103 (92.8%) were women. The mean age at presentation was 39.3 years (SD ± 11.6). The most common organ systems that were involved were musculoskeletal system (95.5%), skin and mucosa (78.4%), and the gastrointestinal and hepatobiliary systems (56%). The maximum sensitivity was for the Kasukawa criteria with a sensitivity of 77.5% (95% CI 68.4-84.6) and specificity of 92.2% (95% CI 87-95.5). The Kahn criteria and Alarcón-Segovia criteria had the maximum specificity; the Alarcón-Segovia criteria had a sensitivity of 69.4% (95% CI 59.8-77.6) and a specificity of 99.4% (95% CI 96.5-99.9), while the Kahn criteria had a sensitivity of 52.3% (95% CI 42.6-61.7) and a specificity of 99.4% (95% CI 96.5-99.9). The sensitivity and specificity of Sharp criteria were 57.7% (95% CI 47.9-66.87) and 90% (95% CI 84.4-93.8), respectively.
混合性结缔组织病(MCTD)最初被描述为一种慢性免疫介导的疾病,具有系统性红斑狼疮、硬皮病和多发性肌炎的重叠特征。我们进行了一项横断面研究来描述MCTD患者的临床和免疫学概况,并比较了四种诊断标准,即Sharp, Kasukawa, Alarcón-Segovia和Khan标准。2007年6月至2017年6月,291例符合纳入标准的患者被纳入研究。111例患者临床诊断为MCTD,其中103例(92.8%)为女性。平均发病年龄为39.3岁(SD±11.6)。最常见的受累器官系统是肌肉骨骼系统(95.5%)、皮肤和粘膜系统(78.4%)、胃肠道和肝胆系统(56%)。Kasukawa标准的最大敏感性为77.5% (95% CI 68.4-84.6),特异性为92.2% (95% CI 87-95.5)。Kahn标准和Alarcón-Segovia标准的特异性最大;Alarcón-Segovia标准的敏感性为69.4% (95% CI 59.8-77.6),特异性为99.4% (95% CI 96.5-99.9),而Kahn标准的敏感性为52.3% (95% CI 42.6-61.7),特异性为99.4% (95% CI 96.5-99.9)。Sharp标准的敏感性和特异性分别为57.7% (95% CI 47.9-66.87)和90% (95% CI 84.4-93.8)。