Simultaneous occurrence of diabetes mellitus and juvenile dermatomyositis: report of two cases.
The simultaneous occurrence of juvenile dermatomyositis (DMS) and diabetes mellitus is described in 2 pediatric patients. Both these patients presented with significant weight loss, polyuria, and polydypsia within a short time of being diagnosed with JDMS, while these patients were taking oral prednisone (40-60 mg/day in divided doses). Laboratory evaluation detected ketonuria, significant hyperglycemia (696 and 913 mg/dL) and low serum levels of insulin and C-peptide. Both these patients were treated with high doses of insulin. Islet cell and GAD65 antibodies were found to be positive in 1 of the patients, pointing toward a diagnosis of insulin-dependent diabetes mellitus. The other patient tested negative for these antibodies and required insulin therapy for approximately 6 months. Steroid-induced diabetes mellitus seemed highly likely in this case. We hypothesize that a common environmental trigger possibly a viral infection might have been responsible in causing 2 different autoimmune pathologies in these genetically predisposed individuals.
Singh
Ranju
R
Department of Pediatrics and Medicine, LSU Health Sciences Center and Children's Hospital, New Orleans, Louisiana 70112, USA.
Cuchacovich
Raquel
R
Gomez
Ricardo
R
Vargas
Alfonso
A
Espinoza
Luis R
LR
Gedalia
Abraham
A
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000628:therapy; D002096:C-Peptide / Q000032:analysis; D003882:Dermatomyositis / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D018570:Risk Assessment; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D002096:C-Peptide; D006442:Glycated Hemoglobin; D007328:Insulin