Diseases associated with a disturbance of connective tissue have been recognized for centuries, but the broad concept of these maladies is contemporary. Rheumatoid arthritis and acute rheumatic fever are identified readily as the commoner connective tissue disorders. The less common disturbances include systemic lupus erythematosus, polyarteritis, systemic scleroderma, acute dermatomyositis, and thrombotic thrombocytopenic purpura. There are selected physicians who accept yet a broader definition and include such maladies as acute glomerulonephritis, chronic nonspecific ulcerative colitis, sarcoidosis, idiopathic thrombocytopenic purpura, and malignant hypertension.
Conclusive proof for or against the inclusion of these latter conditions in the connective tissue group is lacking. One of the strongest arguments for inclusion is the clinical response to steroids, similar to that in the accepted connective tissue category. I do not accept this evidence as convincing, however, and believe that we should limit our concept rather than broaden it. In this presentation, therefore, I have considered