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Mixed Connective Tissue Disease with an Unclassifiable Scleroderma-Like Pattern

Name: Mixed Connective Tissue Disease with an Unclassifiable Scleroderma-Like Pattern
Creator: Miguel Antonio Mesa Navas
Published: 2026-09-04

Mixed Connective Tissue Disease (anti-RNP+)Scleroderma-Like Pattern (Unclassifiable Cutolo Subtype)Moderate to Severe

A patient with mixed connective tissue disease, strongly positive anti-RNP antibodies, and a scleroderma-like capillaroscopic pattern featuring megacapillaries and arborizing forms.

AuthorMiguel Antonio Mesa Navas

Added to Capillaroscopy.comSeptember 4, 2026

Clinical context

The patient has a diagnosis of mixed connective tissue disease. Laboratory testing showed an ANA titer of 1:1280 with a speckled pattern; anti-Ro and anti-La antibodies were negative, anti-Sm was 16.4, and anti-RNP was greater than 200. Anticardiolipin IgG/IgM and anti-β2-glycoprotein I IgG/IgM antibodies were negative.

Capillaroscopy

Capillaroscopy shows megacapillaries, but their distribution does not fit the typical organization of any early, active, or late Cutolo subtype. The overall morphology is therefore classified as a scleroderma-like pattern. Arborizing capillaries are also evident. The quantitative dataset reports a mean capillary density of 5.69/mm, enlarged capillaries in 78.7%, megacapillaries in 6.0%, and ramified forms in 4.7%.

Key Capillaroscopic Findings

Reduced capillary density (5.69/mm)
Frequent enlarged capillaries (78.7%) and megacapillaries (6.0%)
Megacapillary distribution not assignable to an early, active, or late Cutolo subtype
Arborizing or ramified capillaries (4.7%)

Mixed Connective Tissue Disease with an Unclassifiable Scleroderma-Like Pattern