Evolution of undifferentiated connective tissue disease

Abstract

Introduction. Undifferentiated connective tissue disease (UCTD) is characterized by symptoms of autoimmune disease that do not meet the criteria for any specific connective tissue disease (CTD). Understanding the progression and potential outcomes of UCTD is critical for patient management and prevention of progression to a differentiated autoimmune disease. Material and methods. Data from longitudinal and retrospective studies on patients with UCTD followed over several years were used. The studies assessed clinical symptoms, serological markers (e.g., ANAs, specific autoantibodies like anti-Ro and anti-La), and genetic predisposition (e.g., HLA typing) to identify factors influencing disease progression or stabilization. Therapeutic interventions included immunosuppressive agents (e.g., hydroxychloroquine, methotrexate) and regular clinical monitoring. Results. Approximately 30-40% of UCTD patients remain in a stable state without progression to a specific CTD over a follow-up period of 5-10 years. Around 20-30% of patients progress to well-defined autoimmune diseases, with lupus, scleroderma, and polymyositis being the most common. Progression predictive factors include high titers of specific autoantibodies, severe initial clinical manifestations (e.g., arthritis, serositis), and certain genetic markers (HLA-DRB1*03). Early intervention with immunosuppressive therapy was associated with better outcomes, reducing the likelihood of progression in high-risk patients. Conclusions. UCTD exhibits a variable clinical course. Identifying patients at high risk for progression through serological and genetic markers is crucial for targeted management. Early therapeutic interventions with immunosuppressive agents and continuous monitoring can significantly improve patient outcomes and prevent disease progression. Future research should aim to refine risk stratification methods.