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Systemic Lupus Erythematosis

Understanding the Lupus and MCTD Connection

May 26, 2025 ·

Learn the key differences between lupus and MCTD, from Raynaud’s phenomenon to the RNP antibody, and why the distinction matters.

When you’re living with lupus, it can feel like every symptom and test is part of the same story. But what happens when new clues emerge, pointing toward a different diagnosis like Mixed Connective Tissue Disorder (MCTD)? Let’s break down the differences, key markers, and why it all matters for your care.

Read more: Understanding the Lupus and MCTD Connection

What Are Lupus and MCTD?

Lupus and MCTD are both systemic autoimmune diseases that cause inflammation throughout the body. They share overlapping symptoms like fatigue, joint pain, rashes, and even a positive ANA (antinuclear antibody) test.

MCTD, however, is what rheumatologists call an “overlap condition.” This means it combines features of lupus, scleroderma, and myositis, creating its own distinct condition. The trick is spotting the subtle differences that suggest it’s not “just lupus.”

Raynaud’s Phenomenon: A Clue to Look Deeper

Raynaud’s phenomenon—where fingers or toes turn white, blue, then red in response to cold or stress—is common in lupus. But when combined with other signs like skin tightening, it raises a red flag for MCTD.

Raynaud’s is also associated with scleroderma, a condition that’s part of the MCTD overlap. If you notice color changes in your fingers or toes, don’t dismiss it as “normal.” It might be a critical clue.

The Role of the RNP Antibody

If your doctor is digging deeper into an autoimmune diagnosis, they’ll often check your antibodies. One of the most important markers for MCTD is the RNP antibody, also called Sm/RNP or U1RNP.

A high RNP antibody level is like a neon sign pointing to MCTD. While lupus can sometimes present with this antibody, its strong presence should encourage doctors to evaluate for features of MCTD like muscle inflammation or fibrosis.

Muscle Inflammation and Skin Tightening

Symptoms like muscle weakness—difficulty combing your hair or climbing stairs—are more common in MCTD. This weakness stems from inflammation in the muscles, something not typically seen in lupus.

Skin tightening is another key difference. If you notice the skin around your fingers, hands, or forearms feels tighter or looks shiny, it’s worth mentioning. These changes point to the scleroderma component of MCTD and are rarely seen in lupus alone.

Why Diagnosis Matters

You might wonder: if the treatments for lupus and MCTD overlap, why does the distinction matter? The answer lies in the complications.

MCTD carries a higher risk of fibrosis—thickening and scarring—in the lungs or esophagus. These complications require different monitoring and treatment strategies than lupus. Knowing you have MCTD allows your doctor to anticipate and manage these risks early.

What Can You Do?

Autoimmune diseases are dynamic, and symptoms can evolve over time. If you’ve been diagnosed with lupus but notice new symptoms like Raynaud’s, muscle weakness, or skin tightening, don’t assume they’re part of the same story.

Discuss your concerns with your doctor and ask about the RNP antibody. It’s a small step that could lead to big insights into your health.

Dr. Elizabeth Ortiz, double board certified Rheumatologist

How CAR-T Could Transform Lupus

May 12, 2025 ·

Learn how CAR-T therapy re-engineers immune cells to target B cells, offering new hope for lupus remission and treatment.

Autoimmunity 101: Why Does Lupus Happen?

Lupus is one of the most complex autoimmune diseases, but at its core, it all starts with the immune system turning on itself. Normally, your immune system is like a factory with a top-notch quality control system. Regulatory cells make sure the immune “robots” attacking bacteria and viruses don’t go rogue and start targeting your healthy tissues.

Read more: How CAR-T Could Transform Lupus

But in lupus, that quality control breaks down. B cells—key players in the immune system—start producing auto-antibodies that mistake your body’s own tissues for invaders. These auto-antibodies cause inflammation, leading to symptoms like joint pain, fatigue, and even organ damage.

CAR-T Therapy: Using Your Immune System to Fight Lupus

Now, here’s where CAR-T therapy comes in. This groundbreaking autoimmune disease therapy doesn’t just manage symptoms—it addresses the problem at its root.

The process begins with a sample of your T cells being taken from your blood. Scientists then re-engineer these cells in a lab, equipping them with new “tools” to recognize and destroy the rogue B cells responsible for lupus. Once they’re ready, these enhanced T cells are reinfused into your body, where they hunt down and eliminate the problem cells.

This therapy has already shown life-changing results in cancer treatment, and early studies in lupus are just as exciting. Patients with severe, treatment-resistant lupus have experienced remission lasting well beyond the expected timeframe.

CAR-T Therapy: Benefits

CAR-T therapy represents a massive leap forward in lupus treatment and research. Imagine a therapy that uses your own immune system to reset itself—this is the promise of CAR-T.

For patients who have tried everything else, this therapy offers hope for long-lasting remission. It’s a perfect example of bioengineering and targeted immune therapy working together to tackle autoimmune diseases at their source.

CAR-T Therapy: Risks

As exciting as CAR-T therapy is, it’s not without challenges. The process requires a round of chemotherapy before the reinfusion, which suppresses the immune system to make room for the re-engineered T cells. This means there’s a risk of infection during treatment.

Additionally, the reintroduced T cells can sometimes cause an inflammatory response, which, while rare, can be severe. And then there’s the cost—right now, CAR-T therapy is incredibly expensive, making it inaccessible for many patients.

Despite these hurdles, researchers are working hard to improve safety, reduce costs, and make this therapy more widely available.

The Future of CAR-T Therapy in Lupus

We’re still in the early days of CAR-T therapy for autoimmune diseases, but the potential is enormous. This therapy isn’t just about treating lupus symptoms; it’s about changing the game entirely.

Key questions remain: Who is the best candidate for CAR-T therapy? What are the long-term effects? And how can we make it safer and more affordable? The good news is that the research is moving fast, and every study brings us closer to answers.

For now, CAR-T therapy offers a glimpse of what’s possible in lupus treatment. It’s an exciting time in autoimmune disease research, and while there’s still work to do, the promise of long-lasting remission gives hope to many.

If you’re living with lupus or know someone who is, keeping up with the latest research is essential. CAR-T therapy isn’t ready for everyone yet, but it’s a perfect example of how science is pushing boundaries to improve lives.

Curious about clinical trials or want to learn more? Check out resources and stay informed about the future of autoimmune disease breakthroughs. Together, we’re moving toward a brighter future for lupus treatment.

Dr. Elizabeth Ortiz, double board certified Rheumatologist

Can you have ANA negative lupus?

March 10, 2025 ·

if your ANA is negative, it can difficult to know if you have systemic lupus erythematosus (SLE)

Getting an autoimmune diagnosis like lupus is a life-changing event. But what we don’t talk about enough is how life-changing the journey to that diagnosis can be. For many, it’s a rollercoaster of confusing symptoms, endless doctor visits, and—often—conflicting test results. One of the most common points of confusion? The ANA test, its results, and what they actually mean when you’re trying to figure out if you have lupus.

Let’s dive into the complexities of the ANA test, what it means for lupus, and why focusing on your symptoms might be the key to getting the answers you need.

[Read more…] about Can you have ANA negative lupus?

Why Primary Care is Essential for Autoimmune Patients

February 3, 2025 ·

Everyone with RA or lupus needs their primary care doctor and rheumatologist

Managing an autoimmune condition can be complex and overwhelming, especially when you’re frequently visiting your rheumatologist. However, it’s crucial not to overlook the importance of your primary care doctor (PCP). Let’s explore how a good relationship with your PCP can benefit your heart health, coordinate your care, and keep you up-to-date on vaccinations.

The Importance of Cardiovascular Health

Heart health is a critical aspect to monitor when living with an autoimmune condition. Conditions like rheumatoid arthritis, lupus, and psoriatic arthritis increase the risk of cardiovascular disease due to chronic inflammation. Your PCP is essential in regularly checking your blood sugar, cholesterol, blood pressure, and weight, ensuring these risk factors are controlled.

[Read more…] about Why Primary Care is Essential for Autoimmune Patients

Can Your Medications Cause Lupus?

January 27, 2025 ·

Drug induced lupus can act like lupus but resolves when the medication is stopped

Drug-induced lupus, a form of lupus caused by certain medications, and not something you hear much about. It differs from the regular “systemic” lupus in multiple ways, including the expected symptoms, the positive blood tests and the prognosis. 

What is Drug-Induced Lupus?

We’ve all heard of lupus, but did you know there’s a version that can be triggered by medications? It is called drug-induced lupus. Unlike the more familiar systemic lupus erythematosus (SLE), which is a chronic autoimmune disease, drug-induced lupus occurs when your body’s immune system reacts to a specific medication.

[Read more…] about Can Your Medications Cause Lupus?
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