Children and adolescents can present with signs and symptoms that are characteristic of more than one connective tissue or inflammatory disorder. This occurrence is more common in children and adolescents compared to adults. In our experience, children's signs and symptoms may evolve over time from those of one connective tissue disease to another. For example, combinations of features of JIA, systemic lupus erythematosus, juvenile dermatomyositis, scleroderma, and vasculitis are seen. These children are best described as having "overlap syndromes" or "undifferentiated connective tissue disease." Treatment should be tailored to organ involvement and underlying pathophysiology rather than be disease specific.
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