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INTRODUCTION it is not clear whether the overlap syndrt me is a fortuitous association of 2 or more dc “initc diseases, or it is a ditsinct clinical entity (I_. As the etiology of most of the connective tiasue diseases (CTD) remains unknown, classification criteria based on clinical and serolcgic manifestations may be of help as an aid to HG diagnosis and the comparison of patients. In the early 1970, Sharp and his colleagues attempted to add a further disease entity to the family of the autoimmune/'rheumatic diseases (2). They named it mixed connective tissue disease (MCTD).