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Diagnostic and management problems in a complex case of connective tissue disease

Diagnostic and management problems in a complex case of connective tissue disease
Diagnostic and management problems in a complex case of connective tissue disease

A 28-year-old Nigerian woman presented with persistent pyrexia, marked pruritus, eosinophilia, myalgias, flitting arthralgias, serositis and massive splenomegaly. Intensive investigation for an infective or neoplastic aetiology proved negative. Empirical treatment for helminthic infections and tuberculosis was unhelpful. Although there were no specific clues to suggest an underlying connective tissue disease, a trial of steriods and azathioprine was introduced, with no obvious response. Her condition deteriorated to a point where it was decided that intravenous immunosuppressive therapy was needed and subsequently, her condition improved remarkably. This patient illustrates the problems in the diagnosis and management of complex disorders, particularly when classical tests for connective tissue diseases are absent. Also, we would like to report that marked pruritus can be associated with connective tissue disease.

Adult, Connective Tissue Diseases, Female, Humans, Immunosuppressive Agents, Pruritus, Case Reports, Journal Article
0032-5473
751-752
Yeap, S.S.
f77af8ae-582d-46ea-ad86-c6b4d2377425
Deighton, C.M.
c28f104a-2cb1-47e6-9e37-c33658609815
Powell, R.J.
e185fb63-eb9d-4610-95c4-88039627a5f5
Read, R.C.
b5caca7b-0063-438a-b703-7ecbb6fc2b51
Finch, R.G.
6492b427-f814-4123-a753-c20502679abe
Yeap, S.S.
f77af8ae-582d-46ea-ad86-c6b4d2377425
Deighton, C.M.
c28f104a-2cb1-47e6-9e37-c33658609815
Powell, R.J.
e185fb63-eb9d-4610-95c4-88039627a5f5
Read, R.C.
b5caca7b-0063-438a-b703-7ecbb6fc2b51
Finch, R.G.
6492b427-f814-4123-a753-c20502679abe

Yeap, S.S., Deighton, C.M., Powell, R.J., Read, R.C. and Finch, R.G. (1995) Diagnostic and management problems in a complex case of connective tissue disease. Postgraduate Medical Journal, 71 (842), 751-752. (doi:10.1136/pgmj.71.842.751).

Record type: Article

Abstract

A 28-year-old Nigerian woman presented with persistent pyrexia, marked pruritus, eosinophilia, myalgias, flitting arthralgias, serositis and massive splenomegaly. Intensive investigation for an infective or neoplastic aetiology proved negative. Empirical treatment for helminthic infections and tuberculosis was unhelpful. Although there were no specific clues to suggest an underlying connective tissue disease, a trial of steriods and azathioprine was introduced, with no obvious response. Her condition deteriorated to a point where it was decided that intravenous immunosuppressive therapy was needed and subsequently, her condition improved remarkably. This patient illustrates the problems in the diagnosis and management of complex disorders, particularly when classical tests for connective tissue diseases are absent. Also, we would like to report that marked pruritus can be associated with connective tissue disease.

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More information

Published date: December 1995
Keywords: Adult, Connective Tissue Diseases, Female, Humans, Immunosuppressive Agents, Pruritus, Case Reports, Journal Article

Identifiers

Local EPrints ID: 416960
URI: http://eprints.soton.ac.uk/id/eprint/416960
ISSN: 0032-5473
PURE UUID: 16a0e9d1-9720-4e82-9e75-69a2c285db51
ORCID for R.C. Read: ORCID iD orcid.org/0000-0002-4297-6728

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Date deposited: 15 Jan 2018 17:31
Last modified: 07 Oct 2020 07:10

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