There is no known cure for pediatric MCTD. But, there is effective treatment which can reduce or stop symptoms. This allows children with MCTD to lead healthy, productive lives.
There is no specific treatment for MCTD. Treatment will be tailored to a child’s pattern of symptoms. Over time, some patients develop mild arthritis and need only symptom relief. Patients who develop lung disease will need steroids and other immune-suppressing medicines.
Raynaud's phenomenon responds well to protection from the cold, such as wearing mittens. Some children with Raynaud's may need drugs, like calcium channel blockers.
Medications used to treat children with MCTD include:
NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)
Drugs like ibuprofen, naproxen and nabumetone are used to control the mild arthritis often seen in MCTD. Up to one-third of children get adequate disease control with the use of NSAIDs alone. Children tolerate these drugs very well. They uncommonly cause side effects like upset stomach.
Prednisone is the drug most often used in the group of medicines called steroids, corticosteroids or glucocorticoids. Other drugs in this group are methylprednisolone or prednisolone. Prednisone (or one of the other steroids) may be used to treat severe arthritis that does not respond to NSAIDs. It is also used to treat pulmonary hypertension.
Prednisone works quickly to calm the immune system and control inflammation. This drug is like cortisone, a natural hormone made by our bodies. At first, high doses of this drug may be given to quickly reduce swelling in the joints or lungs. As your child improves, the steroid dose will be reduced over time to prevent side effects that are common at higher doses. Side effects depend on both the dose and length of therapy.
Common side effects include weight gain, increased appetite, increased risk for infections and facial swelling. Over a long period of time, the drug may cause decreased bone calcium content, cataracts, high blood pressure and a slowed growth rate. The doctor will try to lower the dose as soon as possible to decrease the risk of side effects, while keeping the disease under control.
Hydroxychloroquine (brand name Plaquenil)
This antimalarial drug is used to treat lupus, given one time a day. Though hydroxychloroquine is most often well-tolerated, some children may have stomach upset.
About 1 in each 3,000-5,000 people who take high doses of hydroxychloroquine will accumulate pigment in the retina of the eye. If this is allowed to progress, it can interfere with a person's eyesight. For this reason, an ophthalmologist (eye doctor) needs to check your child's eyes once a year while your child is taking this medicine. If the eye doctor finds any pigment build up, hydroxychloroquine will be stopped before any visual problems develop.
For patients with more severe symptoms like lung, kidney or central nervous system disease, drugs called immunosuppressives may be used. These drugs calm the immune system by preventing new autoimmune cells from being formed.