UCTD, low MCV, low MCH and low neutrophils

Posted by aayre @aayre, Thu, May 30 10:15pm

My Rheumatologist diagnosed me with Undifferentiated Connective Tissue Disease in December. I am taking Plaquenil daily. My MCV and MCH have always been low for as far back as I can remember; however, my iron levels and ferritin are normal. Recently my Neutrophils have also dropped. Any ideas on what the heck is going on with me??? I’m miserable every day. My body hurts 24/7. I don’t feel the Plaquenil is doing anything.

Reviewed by Barbara Goldstein, MD (February 01, 2016)

Undifferentiated connective tissue disease (UCTD) is a systemic autoimmune disease. This means the body's natural immune system does not behave normally. Instead of serving to fight infections such as bacteria and viruses, the body's own immune system attacks itself. In UCTD, autoimmunity may cause the immune system to attack specific parts of the body, resulting in a variety of problems.
The phrase "connective tissue disease" is used to describe the diseases of the immune system that are treated primarily by rheumatologists. These represent systemic autoimmune diseases that often involve the joints, cartilage, muscles and skin. They can also involve any other organ system such as the eyes, heart, lungs, kidneys, gastrointestinal tract, bone marrow, nervous system and blood vessels. Examples of connective tissue diseases include lupus, scleroderma, rheumatoid arthritis, Sjögren's syndrome, myositis and vasculitis.
There are many people who have features of connective tissue disease, however, they do not fulfill the diagnostic criteria established for any one disease. In such circumstances, they are often considered to have "undifferentiated" connective tissue disease. Over time, people with UCTD may evolve into one of the more specific connective tissue diseases, such as lupus, Sjögren's or scleroderma.

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@aayre This sounds very difficult for you. Do you take any other medications? As a retired nurse, I would suggest 2 things: 1. If you also take other medications, talk to your pharmacist to see if there are any interactions between the medications, and 2. keep a list of all the things bothering you—what you feel, when it happens, how long it lasts, does it get better with time or worse, is there anything you do to make it better, etc. Write down everything! Keep these notes on a small notebook. Take it with you to your next appointment and have a long talk about all the side effects. Go sooner if things get really bad. I would also suggest you not follow your lab values too closely. You can always ask the MD if there are any specific ones you Should follow. I’m really sorry you’re feeling miserable. Please stay in touch—I care about you. Becky

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I literally feel your pain. In addition to osteoarthritis in my neck spine and hips, I’ve experience chronic muscle pain, through my body for nearly 15 years. Every year it gets worse. I’m on my 6th rheumatologist and gave seen 5 neurologist as well as other specialists. It’s frustrating. Hang in there and thanks for posting. BD

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@tigerlilly

Reviewed by Barbara Goldstein, MD (February 01, 2016)

Undifferentiated connective tissue disease (UCTD) is a systemic autoimmune disease. This means the body's natural immune system does not behave normally. Instead of serving to fight infections such as bacteria and viruses, the body's own immune system attacks itself. In UCTD, autoimmunity may cause the immune system to attack specific parts of the body, resulting in a variety of problems.
The phrase "connective tissue disease" is used to describe the diseases of the immune system that are treated primarily by rheumatologists. These represent systemic autoimmune diseases that often involve the joints, cartilage, muscles and skin. They can also involve any other organ system such as the eyes, heart, lungs, kidneys, gastrointestinal tract, bone marrow, nervous system and blood vessels. Examples of connective tissue diseases include lupus, scleroderma, rheumatoid arthritis, Sjögren's syndrome, myositis and vasculitis.
There are many people who have features of connective tissue disease, however, they do not fulfill the diagnostic criteria established for any one disease. In such circumstances, they are often considered to have "undifferentiated" connective tissue disease. Over time, people with UCTD may evolve into one of the more specific connective tissue diseases, such as lupus, Sjögren's or scleroderma.

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Thank you, Dr. Goldstein, for your very helpful explanation regarding the vagaries of UCTD. Although I consider myself very grateful for such a non-threatening "disorder" (my blood results indicated that I have 3 out of the 4 markers for Lupus), I can't help wondering if there is something to counteract the chronic fatigue that accompanies the disorder. Having been put on Hydroxychloroquine, any pain that arise can be easily eliminated with Advil, Alive or Aspirin (and for that I am truly grateful). I'm 72; normally active (exercise religiously) but no matter how much sleep I get, I am chronically tired. Is it unrealistic to think that there may be something to help with this in an effort to experience "quality of life?" I've heard all the "caveats" (Are you depressed?). If I am, I certainly don't know about it (72; retired; love to go line dancing at a Senior Center here in Tulsa; just had a dog certified as as "Therapy Dog;" love being retired). Is fatigue just "part of the package" for which there is no remedy? In other words, be grateful that's all I have to deal with? It's enough to tempt one into getting some pep pills "off the street" in order to enjoy what's left of life on Planet Earth! (that's a hyperbolic comment, but don't think it hasn't crossed my mind). I'm sending this in case others have felt likewise (and wonder if I'm just lacking in the "grit" to wade through the fatigue). Thanks in advance for your perspective in this matter.

Jupiter 2016

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@carolhastings

Thank you, Dr. Goldstein, for your very helpful explanation regarding the vagaries of UCTD. Although I consider myself very grateful for such a non-threatening "disorder" (my blood results indicated that I have 3 out of the 4 markers for Lupus), I can't help wondering if there is something to counteract the chronic fatigue that accompanies the disorder. Having been put on Hydroxychloroquine, any pain that arise can be easily eliminated with Advil, Alive or Aspirin (and for that I am truly grateful). I'm 72; normally active (exercise religiously) but no matter how much sleep I get, I am chronically tired. Is it unrealistic to think that there may be something to help with this in an effort to experience "quality of life?" I've heard all the "caveats" (Are you depressed?). If I am, I certainly don't know about it (72; retired; love to go line dancing at a Senior Center here in Tulsa; just had a dog certified as as "Therapy Dog;" love being retired). Is fatigue just "part of the package" for which there is no remedy? In other words, be grateful that's all I have to deal with? It's enough to tempt one into getting some pep pills "off the street" in order to enjoy what's left of life on Planet Earth! (that's a hyperbolic comment, but don't think it hasn't crossed my mind). I'm sending this in case others have felt likewise (and wonder if I'm just lacking in the "grit" to wade through the fatigue). Thanks in advance for your perspective in this matter.

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Thank you for voicing what so many of us feel! Grateful to have a non-life threatening disease but tired of the fatigue! I am lucky enough to get a 4-5 good energy days in a row but after that I am exhausted by 5 pm or earlier. I also try to stay active but it’s tough some days.

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