Admitted with epistaxis, discharged on immunosuppressants! - An Unusual Presentation of Mixed Connective Tissue Disease

Mixed Connective Tissue Disease (MCTD) is a complex disease that is a combination of several other clinical conditions, including systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and polymyositis/dermatomyositis (PM/DM). What makes MCTD challenging is the fact that there are no current management guidelines. Instead, treatment is usually chosen based on organ involvement using SLE, SSc, and PM/DM guidelines. In this paper, we will discuss an unusual presentation of MCTD, the workup that led to the diagnosis, the immunological profile, and the management plan for this rare disease.