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I can only give more anecdotal possibilities.

If steroids helped at all, then there was definitely SOME inflammation going on (but also that was noted by sed rate & CRP).

I use mobic 15mg myself, and at first thought it wasnt helping, until I accidently missed a day, and realized the real problem is that I started it during a lull in pain. It actually helps a LOT for joint pain. Mobic doesnt help me at all with fatigue though. I think the dosage of steroid and/or nsaid depends on the patient. Some do better on high dose steroids, but if a low dose steroid combo works better for your daughter than thats great news as long term steroid use isnt good.

Yes, you can have MCTD with high dsdna. Think of MCTD not as a seperate disease, but multiple diseases. (hence, mixed or multiple connective tissue disease). Its like having lupus+sjrogen's+whatever... A mixture of symptoms from each one combines to make MCTD. DSDNA is positive in mctds sometimes, as it can also positive in auto immune hepatitis, sjrogens, RA, and others.
So, in a diagnosis of MCTD the rheumatologist may say it swings more towards this disease or that, but will look at the major complaint symptoms individually.

In the end, in *most* cases of autoimmune, once its known that the issues are auto immune they are generally ALL treated with the same general things. Methotrexate & corticosteroids are drugs used for pretty much every one. RA, lupus, Psoratic arthritis, etc. etc etc. I think maybe like plaquenil may not be really beneficial for some diseases but is for others.... but I could be wrong.

With a dramatic increase in DSDNA (greater than %30) it means the kidneys should be watched closely. Doesnt mean necessarily anything will happen, just means they should keep their eyes open. You said the DSDNA was IFA, but that doesnt sound like an IFA result (IFA results are reported in titers, ie 1:10, 1:20, 1:40 etc etc) and you cannot comapre the IFA titer to the original DSDNA test with a range of 0-4 5-9 10+... its like - apples & oranges.

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