How should rheumatologists address the impact on patients who are initially diagnosed with SLE based on positive ANA, but later reclassified as having UCTD?   

I experience this question a bit differently. Patients who are told they have a diagnosis are frequently living in a certain mindset with a certain expectation and possibly even a fear of the alteration of their life. The patient with a diagnosis trusted a doctor to give them sound and honest advice...

This is not a very clear question, IMHO. We never base the diagnosis of SLE on a positive ANA. You can be diagnosed with SLE even without an ANA (e.g., those with positive anti-SSA and negative ANA).  Why was this patient initially diagnosed with SLE and then later reclassified as UCTD (undif...

ANA of SLE patients can become negative on effective treatment. I would not change the diagnosis for this reason.

Not sure I have seen any "impact" re: this; usually does not really alter the initial treatment approach and one should always be mindful that patients at risk for autoimmunity may develop overlapping disease features (that may or may not be associated with presence of antinuclear antibodies).