Mixed immunofluorescence findings in mixed connective tissue disease

An adult female with mixed connective tissue disease is described who had non-scarring alopecia, telangiectases, Raynaud's phenomenon and swollen hands. No clinical signs of SLE and only modest signs of myositis were present. High levels of RNP antibodies were detected in serum and direct immunofluorescence showed IgG staining of epidermal nuclei with a speckled pattern. Elution techniques performed on circulating lymphoid cells showed mixed features of both LE and scleroderma, namely antibodies to basal zone, to epidermal basal cells and to endothelial cells in mid-dermis.