Endocrine Abstracts

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). A 73-year-old man was referred to the 3rd hospital of Tashkent Medical Academy with signs of kidney lesion and the history of treatment at two other medical settings.

Complaints on admission

Exertional dyspnea, productive cough, high temperature (38^o C) with chill and perspiration, palpitation, dryness in the mouth with no saliva, pain in joints, including the maxillary ones, nausea and vomiting, anorexia, 10 kg weight loss for 3 months, and expressed general asthenia.

Examination of the patient 2 weeks later: the general condition is satisfactory, slight general weakness; sometimes coughing with light sputum, 2 kg weight gain. Further recommendations for 1 month: prednisolone (8 tab./day), vitamin E (1 caps. by 200 mg twice a day), clopidogrel 75 mg/day. in the evening after meals, calcium D3 (1 tab. twice aday), omeprazole 20 mg/day. Conclusion: 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).