DIAGNOSTIC AND MANAGEMENT PROBLEMS IN A COMPLEX CASE OF CONNECTIVE-TISSUE DISEASE

A 28-year-old Nigerian woman presented with persistent pyrexia, marked pruritis, eosinophilia, myalgias, flitting arthralgias, serositis and massive splenomegaly. Intensive investigation for an infective or neo plastic aetiology proved negative. Empirical treatment for helminthic infections and tuberculosis was unhelpful. Although there were no spec ific 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 intr avenous immunosuppressive therapy was needed and subsequently, her con dition improved remarkably. This patient illustrates the problems in t he diagnosis and management of complex disorders, particularly when cl assical tests for connective tissue diseases are absent. Also, we woul d like to report that marked pruritis can be associated with connectiv e tissue disease