Akademik Veri Yönetim Sistemi
POSTGRADUATE MEDICINE, cilt.137, sa.8, ss.839-849, 2025 (SCI-Expanded, Scopus)
ObjectiveThis study aimed to evaluate the progression rate of undifferentiated connective tissue disease (UCTD) to defined CTDs by applying two sets of UCTD criteria alongside the most recent CTD classification criteria.MethodsA retrospective review was conducted on 1342 patients who underwent antinuclear antibody (ANA) testing at a rheumatology outpatient clinic between February 2021 and February 2023. UCTD was defined in patients exhibiting autoimmune features without meeting criteria for a specific CTD. Patients were categorized into two groups: (1) ANA-positive with disease duration >= 3 years (Mosca) and (2) positive finding for at least one of the following serological markers (ANA, rheumatoid factor, anti-scl 70, SS-A or SS-B, Jo-1 antibody, sedimentation rate (two times normal), C-reactive protein) in the absence of infection, regardless of disease duration (Kinder).ResultsA total of 119 patients with UCTD (95% women) were evaluated, with a median follow-up time of 34.1 (IQR: 21.4-52.7) months. Sixteen patients (13%) progressed to defined CTDs or rheumatoid arthritis (RA): primary Sj & ouml;gren's syndrome (n = 7), RA (n = 5), systemic sclerosis (n = 3), and systemic lupus erythematosus (n = 1). The median time for evolution was 34.8 (IQR: 17.9-54.8) months. Approximately half of the patients met either set of UCTD criteria. There was no difference in either the progression rate (12.1% vs. 14.8%, p = 0.81) or the time to classification as CTD or RA [28.2 (11.7-39.9) vs. 39.2 (24.6-67.4) months, p = 0.14] when using the Kinder or Mosca criteria.ConclusionApplication of the most recent CTD classification criteria revealed a 13% progression rate from UCTD to defined CTDs or RA during a three-year median follow-up. In patients with suspected CTD, evaluation of serological markers beyond ANA may contribute to the diagnosis of UCTD. The establishment of standardized definitions for UCTD is essential to improve the methodological consistency of future studies and to facilitate more accurate prognostic assessments.