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Simultaneous Occurrence of Diabetes Mellitus and Juvenile Dermatomyositis: Report of Two Cases

Raquel Cuchacovich, MD

Ricardo Gomez, MD

Alfonso Vargas, MD

Luis R. Espinoza, MD

Abraham Gedalia, MD

Department of Pediatrics and Medicine, LSU Health Sciences Center and Children's Hospital, New Orleans, Louisiana

The simultaneous occurrence of juvenile dermatomyositis (JDMS) 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 913mg/d L) and low serum levels of insulin and Cpeptide. 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.

Clinical Pediatrics, Vol. 42, No. 5, 459-462 (2003)
DOI: 10.1177/000992280304200514


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