Sir.—We read with interest the report of Collen et al that detailed a case of primary ovarian failure, juvenile rheumatoid arthritis (JRA), and vitiligo (Journal 133:598-600, 1979). We, too, have studied a patient with JRA and an autoimmune polyendocrinopathy.
Report of a Case.—A 15-year-old girl with chronic eczema had insulin-dependent diabetes mellitus (DM) at age 6 years, euthyroid goiter at age 9 years, and debilitating polyarticular JRA with subcutaneous nodules at age 12 years. There was a family history of DM and goiter in the mother and the maternal relatives. After therapy with thyroid and gold, the goiter regressed and the arthritis improved.
Laboratory tests performed at age 13 years showed the following levels: fasting blood glucose, 208 mg/dL; urinalysis, 4 + for glucose, negative acetone, and protein; sedimentation rate, 33 mm/min; VDRL, negative; antinuclear antibody, 1:32, 768; rheumatoid factor, 1:640; antiextractable nuclear antigen, negative; anti-DNA, 27% (normal,
FISHER M, NUSSBAUM M, ABRAMS CAL, SHENKER IR. Diabetes Mellitus, Hashimoto's Thyroiditis, and Juvenile Rheumatoid Arthritis. Am J Dis Child. 1980;134(1):93-94. doi:10.1001/archpedi.1980.02130130075029