Ex Juvantibus diagnosis of undifferentiated diffuse connective tissue disease

Abstract

The term "undifferentiated connective tissue disease" (UCTD) represents a stage of disease where clinical symptoms and serological abnormalities suggest autoimmune disease, but they are not sufficient to fulfill the diagnostic criteria of any well-established connective tissue disease (CTD). It is diagnosed when there is evidence of an existing autoimmune condition which does not meet the criteria for any specific autoimmune disease. This clinical case is of interest in terms of late diagnosis of undifferentiated diffuse connective tissue disease, that, most likely, was difficult to make due to underestimation of multi-organ manifestations of the disease, including the Sjogren's syndrome which is characteristic for collagenosis, as well as due to refusal of the patient from biopsy. The pulse therapy under the umbrella of the antibiotic have rendered a pronounced positive effect and confirmed the main diagnosis on the basis of the effect of treatment (diagnosis ex juvantibus). Hence, in the presence of signs of multi-organ damage, physicians should keep in mind the possibility of a diffuse connective tissue disease.