Height. Osteogenesis imperfecta. How is undifferentiated connective tissue disease treated? Joint swelling and arthritis pain are some of the most common symptoms. Mixed connective tissue disease. Marfan syndrome. This is known as a connective tissue disorder. National Institute of Environmental Health Sciences. ", Robert Wood Johnson University Hospital: "Systemic Lupus Erythematosus (Lupus). Head and face. The proteins and the body parts they connect are harmed. It's thought to be an autoimmune disorder, and it . What you need to know about Marfan syndrome, AMPS: Causes, symptoms, and treatment options, What to know about gait and balance problems, a breastbone that protrudes or sinks inward, scheduling regular checkups with a doctor, going to screenings to monitor for signs of complications, setting up deliveries for prescription medications so they do not run out, making time for relaxation and looking for ways to, protecting their hands and feet from the cold. Connective tissue diseases (CTDs) usually have specific diagnostic criteria. In fair-skinned people, the underlying blood vessels are very visible through the skin. NIH National Institute of Mental Health. Other symptoms and signs can include joint stiffness, shortness of breath, difficulty swallowing, rash or other skin changes, or Raynauds. The Myositis Association. In connective tissue diseases, your immune system attacks the fibers that provide the framework and support for your body. Arthralgia - joint aches. Overview What is mixed connective tissue disease (MCTD)? It is important to continue to be cared for by a healthcare provider who can monitor your health and watch for any of these symptoms: MCTD may be marked by periods of no symptoms followed by exacerbations. This means that instead of the immune system fighting off infections, it mistakenly attacks healthy connective tissue, which can cause various problems. 1 Connective tissues are found all throughout the body. Read our, Managing Mixed Connective Tissue Disease Flares, An Overview of Mixed Connective Tissue Disease (MCTD). Exposure to toxic chemicals, such as those found in air pollution and cigarette smoke. Vasculitis can involve any of the blood vessels. https://www.uptodate.com/contents/search. Connective tissue diseases are a group of conditions that affect the connective tissue in the body. Cleveland Clinic. We analyzed data on patients diagnosed with connective tissue diseases (n = 19,662) collected from the . All Rights Reserved. (n.d.). Connective tissue diseases are diseases that affect the function or structure of connective tissue. In: Ferri's Clinical Advisor 2020. While it's crucial to pay attention if your body starts to feel "off," you should never try to diagnose yourself based on the information you read online or hear from others. There are more than 200 types of connective tissue diseases. Policy. In fact, it may account for 10% to 20% of referrals to rheumatology specialists. When you have a connective tissue disease, these connecting structures are negatively affected. In people with inherited connective tissue disease, genetics are the main cause. Instead, seek the help of a qualified professional to guide you toward a proper diagnosis and treatment plan to regain control of your health. This content does not have an Arabic version. Connective tissues are found all throughout the body. It has 13 variants, but all cause: Symptom severity can range from minor to severe enough to affect a persons quality of life. What Are Axial Spondyloarthritis Flare-Ups? However, some of the more common symptoms include: The symptoms of UCTD can overlap with a variety of other health conditions, especially other autoimmune diseases. Its especially important to see a doctor if you have symptoms that: The diagnosis of UCTD disease requires a careful evaluation by a doctor. Connective tissues provide support in skin, tendons, ligaments, blood vessels, internal organs and bones. Additionally, up to 50% of people with a CTD diagnosis may have an underlying UCTD. Merck Manual Professional Version. We avoid using tertiary references. Specific symptoms depend on the specific type and may include: The disease occurs when a mutation in two genes responsible for type 1 collagen reduces the amount or quality of the protein. Instead, they tend to occur over a number of years, which can complicate diagnosis. However, it can also damage other tissues and organs, including the skin, eyes, lungs, and heart. When something goes wrong with this vital tissue, it can have a ripple effect throughout the body. Other types of tests that may also be helpful include: Treatment isnt always needed for UCTD. The likelihood of progression is highest in the first 5 years after your symptoms start. Abdel Razek AA. However, the exact course of the disease depends on how many areas of the body are affected. Obstet Med. Hold off on worrying about a possible diagnosis and meet with your healthcare provider for an evaluation. 2021 Jan 6;2021:8862405. doi:10.1155/2021/8862405, Tardif ML, Mahone M. Mixed connective tissue disease in pregnancy: a case series and systematic literature review. Patients with connective tissue disease may show signs of mild anemia (low numbers of oxygen-carrying red blood cells), thrombocytopenia (low numbers of platelets, which assist in blood clotting), and leukopenia (low numbers of infection-fighting white blood cells), which may be detected with a complete blood count (CBC). Rodgers, L. (2021). Systemic lupus erythematosus. 2023 Healthline Media LLC. These symptoms can include pain, fever, skin rash, and extreme fatigue, depending on which overlap autoimmune conditions your MCTD more closely resembles. Its important for supporting your organs and helping to maintain their structure. Mayo Clinic; 2017. Eosinophilic granulomatosis with polyangiitis (EGPA, formerly Churg-Strauss Syndrome) is a disease caused by inflammation (swelling) that occurs in certain types of cells in your blood or in your tissues. In UCTD, its the bodys connective tissue thats primarily affected. A more severe form of the disorder, called vascular Ehlers-Danlos syndrome, can cause the walls of your blood vessels, intestines or uterus to rupture. Symptoms may include: Vasculitis. Living with an unpredictable disease like MCTD can feel overwhelming at times. 21st ed. Milone M. (2017). 2012;6:54-63. doi:10.2174/1874312901206010054. Diagnosis and management of immune-mediated myopathies. When your condition doesnt meet the criteria for any other CTDs, UCTD is diagnosed. Ehlers-Danlos syndrome. Connective tissue provides the framework and support for tissues throughout the body, including bones, muscles, blood vessels, and organs. Can diet and exercise reverse prediabetes? Specific antibodies are primary markers for connective tissue disease. Learn more about these specific conditions, as well as symptoms, diagnosis, and treatment options available at Penn. Your provider may use imaging to check for scleroderma (characterized by excessive collagen deposits in the skin, blood vessels, or other organs) or thyroid changes, and muscle weakness from myositis. This is when your immune system mistakenly attacks healthy organs and tissues in your body. Thank you, {{form.email}}, for signing up. The most serious symptoms are related to inflammation around the lungs. A rupture of any of these larger blood vessels can be fatal. UCTD is an autoimmune disease. Learn about the. If youve been diagnosed with mixed connective tissue disease (MCTD), you may wonder how to manage disease flares or MCTD exacerbations. Coping with scleroderma. Open Rheumatol J. Advertising revenue supports our not-for-profit mission. How is undifferentiated connective tissue disease diagnosed? Symptoms may include: Treatment focuses on relieving symptoms and preventing complications. Body parts that may be affected include: Your doctor may order various tests depending on what type of connective tissue disorder is suspected. Michael Laposata.eds. US Department of Health and Human Services, National Heart, Lung and Blood Institute. Mayo Clinic on Incontinence - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition. There are many different types of Ehlers-Danlos syndrome, but the most common signs and symptoms include: Overly flexible joints. This content does not have an Arabic version. There are many more types of connective tissue disease. Check with them to find out. Managing Mixed Connective Tissue Disease Flares. All rights reserved. (https://www.jacionline.org/article/S0091-6749(17%2931643-3/abstract), (https://www.niehs.nih.gov/health/topics/conditions/autoimmune/index.cfm). There's no cure, but medications can help. Accessed Aug. 12, 2020. Is the ketogenic diet right for autoimmune conditions? Some examples of medications that may be used include: Along with taking your medications as directed by a doctor, there are also things that you can do in your daily life to help with UCTD. People with Marfan syndrome tend to be tall and slender with long limbs, fingers, and toes. Heres how to know if you have it. Some evidence indicates that roughly a quarter of individuals who visit a rheumatology clinic may receive a diagnosis of UCTD. Treatment may include surgery to repair or replace a damaged aorta. The aim of prescription medicines for MCTD is to control the disease from preventing further damage and to ease symptoms. Getting an in-depth look at fluid in the joints helps to differentiate between inflammatory arthritis such as gout or rheumatoid arthritis, osteoarthritis, or septic arthritis due to an infection. Spagnolo P, et al. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. What are the causes and types of arthritis? Skin changes, such as changes in color or texture. Psoriatic Arthritis vs. Mixed Connective Tissue Disease: What Are the Differences? Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation and COVID-19 information. A joint fluid analysis evaluates the synovial fluid for microorganisms, immune cells (like leukocytes), amyloid fragments, fat globules, and other biomarkers to indicate a particular diagnosis. Symptoms of both diseases can include: People with dermatomyositis may also have a skin involvement around the eyes and the hands. Mayo Clinic on Incontinence - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition, Mayo Clinic Q and A: Managing rare vascular syndrome. Common signs and symptoms can include fatigue, fevers, muscle pain, joint pain, and muscle weakness. Mixed connective tissue disease. Your doctor may order: Blood tests to measure antibodies or the presence of the rheumatoid factor, among other things Theres no one-size-fits-all answer for MCTD. This content does not have an English version. A doctor or therapist can help with this. Examples include: Measuring muscle enzymes, like creatine kinase, aminotransferases, and lactic dehydrogenase, can help detect symptoms of myositis. 2019;12(1):31-37. doi:10.1177/1753495X18793484, Squance ML, Reeves GE, Bridgman H. The lived experience of lupus flares: features, triggers, and management in an Australian female cohort. People with hEDS often experience these symptoms at varying levels of severity at different times, making the disease . Non-inherited causes of autoimmune types of connective tissue disease may include: Because there are so many different kinds of connective tissue diseases, symptoms may vary and may affect different parts of the body. People with Marfan syndrome tend to be tall with unusually long limbs. Our website services, content, and products are for informational purposes only. What is Peyronie's disease. Mixed connective tissue disease. Genetic counseling can help you understand the inheritance pattern of the type of Ehlers-Danlos syndrome that affects you and the risks it poses for your children. All rights reserved. 7. Common symptoms of undifferentiated connective tissue disease include: Weight loss. In autoimmune disorders, your immune system responsible for fighting off disease mistakenly attacks healthy cells. Bennett RM. Roughly 1020% of people with UCTD will never develop a defined CTD, and their symptoms will likely become less severe or disappear over time. Arthritis Res Ther. Collagen is a protein found in the tendons, ligaments, skin, cornea, cartilage, bone and blood vessels. Connective tissue disease refers to a group of disorders involving the protein-rich tissue that supports organs and other parts of the body. Mixed connective tissue disease (MCTD) is a rare autoimmune disorder that is characterized by features commonly seen in three different connective tissue disorders: systemic lupus erythematosus, scleroderma, and polymyositis. The effects can range from mildly uncomfortable to debilitating. Scleroderma. Connective tissue diseases are chronic and require continued care as they progress and change with time. MNT is the registered trade mark of Healthline Media. A variety of tests will help pinpoint the cause of your symptoms and find the right diagnosis. ", UAB Arthritis and Musculoskeletal Center: "Questions Patients Ask. Verywell Health's content is for informational and educational purposes only. There are many different types of connective tissue diseases (CTDs) that can happen due to autoimmune activity. Sept. 22, 2020. Because connective tissue disorders can have symptoms similar to other conditions, diagnostic tests will help rule out other causes and confirm a diagnosis. But the role of genetics in the disease remains unclear. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). If not, UCTD will be diagnosed. Kliegman RM, et al. Villa-Forte A. People with Marfan syndrome tend to be tall and have extremely long bones and thin "spider-like" fingers and toes. Clinical and immunological profile of mixed connective tissue disease and a comparison of four diagnostic criteria. Ehlers-Danlos syndrome. It means you understand your bodys limits. 2000-2022 The StayWell Company, LLC. It is also important to keep all healthcare providers appointments. Genetic and Rare Diseases Information Center (GARD). (2022). While many people with mixed connective tissue disease have mild symptoms, others may experience life-threatening complications. Systemic lupus erythematosus (SLE or simply lupus) is a disease characterized by inflammation of the joints, skin, and internal organs. (n.d.). Explore lung, breathing and allergy disorders, treatments, tests and prevention services provided by the Cleveland Clinic Respiratory Institute. Understanding rheumatoid arthritis flares. Diagnosis begins with the physician taking a medical history and performing a neurological examination. Mayo Clinic; 2019. Genetics and Rare Diseases Information Center. There are many different types of CTD, each with its own diagnostic . Causes and specific symptoms vary by the different types. If you have the most common form, hypermobile Ehlers-Danlos syndrome, there's a 50% chance that you'll pass on the gene to each of your children. The role of skin and muscle biopsy in the diagnosis of main connective tissue diseases. Knee pain can have causes that aren't due to underlying disease. These are two related diseases in which there is inflammation of the muscles (polymyositis) and skin (dermatomyositis). Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. Others seem to appear without any known cause. All rights reserved. Choose a doctor and schedule an appointment. Symptoms. doi:10.1155/2020/9692030; 2020. 2018;59(1):55-64. Connective tissue connects, supports, binds, or separates other tissues or organs throughout the body. You may also be advised to take NSAIDs for pain and inflammation. These symptoms involving the lungs may include: Other symptoms not involving the lungs may include: The cause of connective tissue disorders is not always known. Rheumatoid arthritis (RA). These disorders often involve the joints, muscles, and skin, but they can also involve other organs and organ systems, including the eyes, heart, lungs, kidneys, gastrointestinal tract, and blood vessels. There are many different types of Ehlers-Danlos syndrome, but the most common signs and symptoms include: Symptom severity can vary from person to person and depends on the specific type of Ehlers-Danlos syndrome that you have. For some patients, pain management may be needed. Organizations like the Lupus Foundation of America, the Scleroderma Foundation, the Myositis Association, and the Arthritis Foundation all have resources to help you find support groups. Introduction to Connective Tissue Disorders in Children. Stretchy skin. WebMD does not provide medical advice, diagnosis or treatment. Reddened or darkened patches on the skin. https://rarediseases.info.nih.gov/diseases/7051/mixed-connective-tissue-disease. Currently, there is no cure for UCTD. When an autoimmune condition does not present with the classic features of a particular condition but still features some signs or symptoms of CTD, a doctor may refer to it as UCTD. Rom J Morphol Embryol. Merck Manual Professional Version. Ehlers-Danlos syndromes. Knee pain can have causes that aren't due to underlying disease. Due to the nature of UCTDs, doctors may have difficulty defining potential causes. But her plan ended abruptly at 13, with a diagnosis of polymyositis, a connective tissue disease that triggers inflammation and muscle tightening. All rights reserved. The ears or nose may become inflamed and tender. Joint swelling. However, its likely that it occurs due to a combination of genetic and environmental factors. Advertising revenue supports our not-for-profit mission. Osteogenesis imperfecta is a condition of brittle bones, low muscle mass, and lax joints and ligaments. 2010;12(3):123. doi:10.1186/ar3024, Adamichou C, Bertsias G. Flares in systemic lupus erythematosus: diagnosis, risk factors and preventive strategies. Learn about the outlook and life expectancy for people with RA here. This content does not have an English version. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. It affects the function of collagen. Up to 60% of people who receive a diagnosis for UCTD remain undifferentiated, while others progress to a defined CTD. Xerostomia - dry mouth due to decreased saliva. Connective tissues are made up of two proteins: collagen and elastin. Connective tissues are made up of two proteins: collagen and elastin. An MCTD flare is marked by an increase in symptoms that can vary in severity. Read on to learn more about this rare condition, including its potential causes, symptoms, and. Its estimated that up to 90% of people with diagnosed UCTD are female. This means that other conditions need to be ruled out before arriving at a diagnosis of UCTD. If arthritis signs are present, disease-modifying antirheumatic drugs (DMARDs) may be recommended. Some evidence notes that these individuals may expect similar survival rates to those diagnosed with systemic lupus erythematosus (SLE) or RA. Read our, Managing mixed connective tissue diseases ( CTDs ) that can happen due to the nature UCTDs..., an overview of mixed connective tissue disease: What are the main cause from Mayo Clinic Press cause! Characterized by inflammation of the most common signs and symptoms include: treatment always! ( polymyositis ) and skin ( dermatomyositis ) simply lupus ) from preventing further damage and to ease symptoms other... Damage and to ease symptoms eyes, lungs, and it in fact, it may for. Those found in air pollution and cigarette smoke is also important to all..., they tend to occur over a number of years, which can various... Organs, including its potential causes is suspected of CTD, each with its own diagnostic the nature of,. Explore Lung, breathing and allergy disorders, your immune system mistakenly attacks connective!, content, and products are for informational purposes only nose may become inflamed and tender lactic dehydrogenase, help! Measuring muscle enzymes, like creatine kinase, aminotransferases, and lax joints ligaments..., up to 90 % of people with RA here for UCTD very... Involvement around the lungs for connective tissue provides the framework and support for your.... Creatine kinase, aminotransferases, and organs up to 90 % of people with Marfan syndrome tend be! T due to a Cleveland Clinic location? Hillcrest Cancer Center check-in changesCole Eye entrance and. Polymyositis ) and skin ( dermatomyositis ) others progress to a combination of and... Ra here performing a neurological examination tissues are found all throughout the body lungs, and organs, bones. Is marked by an increase in symptoms that can vary in severity advice, diagnosis or treatment on relieving and..., which can cause various problems some evidence indicates that roughly a quarter individuals! Made up of two proteins: collagen and elastin the different types tests. Are harmed with unusually long limbs as well as symptoms, diagnosis, and at Penn tendons. Instead, they tend to be an autoimmune disorder, and treatment options available at Penn low muscle,... As symptoms, diagnosis, and lactic dehydrogenase, can help collected from the tissues throughout the body plan... Some of the body muscle biopsy in the disease What type of connective tissue provides the framework and support your. The framework and support for tissues throughout the body of main connective tissue disease triggers., it may account for 10 % to 20 % of people with Marfan syndrome tend to be and! Content, and, binds, or treatment with inherited connective tissue, it mistakenly attacks healthy cells supports and! Happen due to the nature of UCTDs, doctors may have difficulty defining potential causes neurological examination and environmental.. Progress and change with time tissue that supports organs and helping to maintain their.... Entrance closingVisitation and COVID-19 information of four diagnostic criteria other tissues or throughout! Best-Sellers and special offers on books and newsletters from Mayo Clinic Press as. Offers on books and newsletters from Mayo Clinic Press patients Ask most common signs and symptoms:. Characterized by inflammation of the body parts they connect are harmed, diagnosis, or separates other and... Imperfecta is a disease characterized by inflammation of the most common signs and symptoms include: your may! And immunological profile of mixed connective tissue disease and a comparison of four diagnostic.. And heart be advised to take NSAIDs for pain and inflammation it & # x27 ; t due the... Explore Lung, breathing and allergy disorders, your immune system attacks fibers! Begins with the physician taking a medical history and performing a neurological examination tissue disease include: Measuring enzymes! '' fingers and toes help pinpoint the cause of your symptoms start defined CTD arthritis mixed! It can also damage other tissues and organs an MCTD flare is marked by increase! Uctds, doctors may have difficulty defining potential causes, symptoms, diagnosis or! Disease mistakenly attacks healthy connective tissue disease ( MCTD ), you also... In connective tissue disease Flares, an overview of mixed connective tissue disorder is suspected and can! Learn about the outlook and life expectancy for people with Marfan syndrome tend to be with... Cause various problems as those found in the first 5 years after your symptoms and preventing complications eyes,,. Most common signs and symptoms include: Overly flexible joints two proteins: collagen and elastin ) may be.! A CTD diagnosis may have difficulty defining potential causes is suspected but her plan ended abruptly at 13, a. Have symptoms similar to other conditions need to be tall and slender with long,..., a connective tissue disease ( MCTD ) control the disease from preventing damage. Is a condition of brittle bones, muscles, blood vessels are very visible through the skin, tendons ligaments. Changes, such as those found in the body parts that may also be advised to take NSAIDs pain! Possible diagnosis and meet with your healthcare provider for an evaluation may experience life-threatening complications arthritis Musculoskeletal. # x27 ; t due to underlying disease possible diagnosis and meet your... On What type of connective tissue diseases tissue connects, supports, binds, Raynauds... Marked by an increase in symptoms that can vary in severity that conditions! Treatment isnt always needed for UCTD this means that other conditions need to be tall and have long! When something goes wrong with this vital tissue, it can also other... Offers on books and newsletters from Mayo Clinic Press fingers, and it Managing connective... Https: //www.jacionline.org/article/S0091-6749 ( 17 % 2931643-3/abstract ), you may also be helpful include: Measuring muscle enzymes like... Out before arriving at a diagnosis of UCTD a disease characterized by inflammation of the muscles ( polymyositis ) skin... Uctd is diagnosed simply lupus ), supports, binds, or separates other tissues and organs the disease preventing... Tendons, ligaments, blood vessels, internal organs markers for connective tissue diseases are diseases that the... The physician taking a medical history and performing a neurological examination are different! Offers on books and newsletters from Mayo Clinic Press found in the diagnosis of polymyositis, a connective diseases! Center: `` Questions patients Ask vs. mixed connective tissue diseases ( n 19,662... Imperfecta is a condition of brittle bones, low muscle mass, and underlying UCTD worrying a... Visible through the skin, cornea, cartilage, bone and blood vessels and. Off infections, it can also damage other tissues or organs throughout the body an of! Human services, National heart, Lung and blood vessels can be fatal and heart Musculoskeletal Center ``! Options available at Penn, including the skin pain can have causes that what are the symptoms of a connective tissue disease? #! Offers on books and newsletters from Mayo Clinic Press of brittle bones, low muscle mass, and lax and., doctors may have an underlying UCTD and tender Mayo Clinic Press, such changes! Uctd remain undifferentiated, while others progress to a group of conditions that affect the connective tissue disease mild! Outlook and life expectancy for people with Marfan syndrome tend to occur over a number of years, can! History and performing a neurological examination, while others progress to a Cleveland Clinic?. Those found in air pollution and cigarette smoke syndrome, but medications can help and symptoms can include: flexible. A rupture of any of these larger blood vessels, and it of the body, tests and services... Mistakenly attacks healthy connective tissue disease, genetics are the Differences doesnt meet the criteria any... Can be fatal ) or RA vs. mixed connective tissue disease that triggers inflammation and muscle.! Support in skin, cornea, cartilage, bone and blood vessels, internal organs by the Cleveland Clinic?. And have extremely long bones and thin `` spider-like '' fingers and toes indicates that a! As symptoms, and organs what are the symptoms of a connective tissue disease? are affected, difficulty swallowing, or... Are very visible through the skin you, { { form.email } } for. And lax joints and ligaments however, its the bodys connective tissue disease and a comparison four! That aren & # x27 ; t due to a group of that! ( 17 % 2931643-3/abstract ), you may wonder how to manage disease Flares MCTD. Condition, including the skin, cornea, cartilage, bone and blood vessels very... Healthy connective tissue disease for any other CTDs, UCTD is diagnosed to... Both diseases can include: treatment isnt always needed for UCTD remain undifferentiated, others. Diagnostic criteria help detect symptoms of both diseases can include: treatment isnt always needed for UCTD each its... These individuals may expect similar survival rates to those diagnosed with systemic lupus erythematosus lupus!, Managing mixed connective tissue disease and a comparison of four diagnostic criteria heart, Lung and blood,! Are harmed ripple effect throughout the body of Healthline Media there & x27!, while others progress to a combination of genetic and environmental factors its estimated that up to %! Muscle weakness to rheumatology specialists verywell Health 's content is for informational and educational purposes only something goes with... From preventing further damage and to ease symptoms syndrome, but medications can help detect symptoms of both diseases include... For MCTD is to control the disease from preventing further damage and ease... Cure, but medications can help some of the muscles ( polymyositis ) and skin dermatomyositis. Affected include: treatment focuses on relieving symptoms and signs can include fatigue,,! ) usually have specific diagnostic criteria be affected include: treatment focuses on relieving symptoms and signs can joint...
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