EARLY UNDIFFERENTIATED CONNECTIVE-TISSUE DISEASE - V - AN INCEPTION COHORT 5 YEARS LATER - DISEASE REMISSIONS AND CHANGES IN DIAGNOSES IN WELL ESTABLISHED AND UNDIFFERENTIATED CONNECTIVE-TISSUE DISEASES

Objective. To review the diagnoses after 5 years in patients who were identified within 12 months of the onset of well established and undif ferentiated connective tissue diseases (CTD); to examine death rates a nd disease remissions in these patients. Methods. This inception cohor t of 410 patients was identified in 10 academic rheumatology practices . They had less than one year of signs and/or symptoms of CTD. Diagnos es of specific well established CTD were made using accepted diagnosti c and classification criteria. The diagnoses after 5 years were determ ined. Results. Patients with well established CTD tended to remain wit h the original diagnosis. The progression of unexplained polyarthritis to rheumatoid arthritis occurred infrequently. Ten percent of patient s with isolated Raynaud's phenomenon progressed to systemic sclerosis (SSc). The 5 year survival was over 90% in all diagnostic categories, with the exception of SSc, in which it was 64%. Conclusion. Patients w ith a well established CTD usually continued with the same diagnosis. Patients with undifferentiated CTD tended to remain undifferentiated o r to remit.