Undifferentiated Connective-Tissue Disease Follow-up

Updated: Apr 16, 2015
  • Author: Bernard Hildebrand, MD, MA; Chief Editor: Herbert S Diamond, MD  more...
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Follow-up

Further Outpatient Care

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  • Patients with UCTD are typically monitored for progression of specific manifestations, evolution to a defined CTD, and safety and efficacy of treatment. The frequency of outpatient visits necessary depends on the severity of disease. During the first 5 years postdiagnosis, the frequency of follow-up visits may be more frequent given the propensity for UCTD to evolve early in the disease course.
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Further Inpatient Care

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  • Inpatient care in patients with undifferentiated connective-tissue disease (UCTD) may be necessary only for complex/urgent diagnostic evaluations or therapeutic reasons.
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Inpatient & Outpatient Medications

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  • Medications are prescribed, adjusted, and monitored as indicated for symptoms and safe medical therapy.
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Transfer

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  • Transfer of care ultimately depends on any complications of UCTD that might require subspecialty medical or surgical care.
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Deterrence/Prevention

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  • Deterrence and prevention of UCTD is directly related to the organ or organs involved. However, appropriate preventive medicine screening and immunizations should be considered annually.
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Complications

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  • The complications of UCTD are related directly to specific organ involvement, susceptibility to infections, drug intolerance/reactions, and drug interactions.
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Prognosis

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  • The prognosis of UCTD depends primarily on the extent of organ involvement.
  • UCTD may evolve into a defined CTD in 20%-40% of patients with UCTD, while 50%-60% of cases remain undifferentiated. [18]
  • Approximately 10%-20% of patients with UCTD have symptoms that subside or remit and never evolve into a defined CTD. [25] The incidence of evolution to a defined CTD is highest during the first 3-5 years of the disease course, [28] and the rate of evolution continues to decrease over time. [29]
  • Patients who develop a defined CTD late have been noted to have milder disease with a lower incidence of serious adverse events and a better prognosis. [15, 29]
  • Survival rates in UCTD are similar to those associated with RA and SLE. [37]
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Patient Education

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  • Patients with UCTD, as well as their immediate family members, should be educated about the prognosis of UCTD and the potential for the disease to evolve into a defined CTD (eg, SLE, SSc, MCTD).
  • Furthermore, education should focus on symptomatic treatment, an appropriate understanding of treatment medications, and the indications for contacting the primary care physician or rheumatologist.
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