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Overview of Autoimmune Disorders of Connective Tissue


Alana M. Nevares

, MD, The University of Vermont Medical Center

Last full review/revision Apr 2020| Content last modified Apr 2020
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In an autoimmune disorder, antibodies or cells produced by the body attack the body’s own tissues. Many autoimmune disorders affect connective tissue and a variety of organs. Connective tissue is the structural tissue that gives strength to joints, tendons, ligaments, and blood vessels.

Autoimmune rheumatic disorders include

Rheumatoid arthritis and spondyloarthritis are examples of other autoimmune disorders that affect connective tissue.

Autoimmune disorders can affect other tissues in the body beside connective tissue, and some people with autoimmune disorders of connective tissue have other kinds of autoimmune disorders, such as Hashimoto thyroiditis (an autoimmune thyroid disorder that can lead to overactivity or underactivity of the thyroid gland).


In autoimmune disorders, inflammation and the immune response may result in connective tissue damage, not only in and around joints but also in other tissues, including vital organs, such as the kidneys and organs in the gastrointestinal tract. The sac that surrounds the heart (pericardium), the membrane that covers the lungs (pleura), and even the brain can be affected. The type and severity of symptoms depend on which organs are affected.

Most autoimmune rheumatic disorders increase the risk of developing cholesterol deposits (plaques) in arteries, resulting in hardening of the arteries (atherosclerosis).


  • A doctor's evaluation

  • Laboratory tests

  • Sometimes established criteria

An autoimmune disorder of connective tissue (also called an autoimmune rheumatic disorder or autoimmune collagen-vascular disorder) is diagnosed on the basis of its particular symptom pattern, the findings during a physical examination, and the results of laboratory tests (such as blood tests and biopsies). For some of these disorders, doctors can also base the diagnosis on an established set of criteria.

Sometimes the symptoms of one disease overlap with those of another so much that doctors cannot make a distinction. In this case, the disorder may be called undifferentiated connective tissue disease or an overlap disease.


  • Corticosteroids and/or other drugs that suppress the immune system

Many autoimmune disorders of connective tissue are treated with corticosteroids, other drugs that suppress the immune system (immunosuppressive drugs), or both.

People who take corticosteroids, such as prednisone, are at risk of fractures related to osteoporosis. To prevent osteoporosis, these people may be given the drugs used to treat osteoporosis, such as bisphosphonates, denosumab, teriparatide, and supplemental vitamin D and calcium. People whose immune system is suppressed by corticosteroids and other drugs and by autoimmune disease itself are often given drugs to prevent infections such as by the fungus Pneumocystis jirovecii (see prevention of pneumonia in immunocompromised people).

In people who have overlap diseases, doctors treat symptoms and organ dysfunction as they develop.

Because people with autoimmune disorders have an increased risk of infection, it is important for them to get recommended vaccinations, such as the influenza vaccine and the pneumococcal vaccine.

Although many people who have autoimmune disorders of connective tissue have tried changing their diet to reduce the inflammation caused by these disorders, as of now there are no compelling scientific data that an "anti-inflammatory" diet can alter the course of autoimmune disorders.

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Ankylosing Spondylitis
Spondyloarthritis refers to a group of connective tissue diseases that cause prominent joint inflammation. Ankylosing spondylitis is a type of spondyloarthritis characterized by inflammation of the spine, large joints, and fingers and toes, resulting in stiffness and pain. Which of the following groups is most likely to develop ankylosing spondylitis?
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