Juvenile rheumatoid arthritis in children with diabetes mellitus

Seven children with insulin-dependent diabetes mellitus were found to have juvenile rheumatoid arthritis; six of these children had the polyarticular form of the disease. All six had positive serology (rheumatoid factor and/or antinuclear antibody) and clinical or serologic evidence of autoimmune diseases usually ascribed to the thyrogastric cluster. Five expressed HLA antigens associated with increased risk for both diabetes and rheumatoid arthritis in adults. Evidence of B cell hyperactivity and impaired T cell response was found in some, but immunoregulatory function was normal in all. The association of these two diseases may be the result of factors other than chance alone, and may be more common than previously suspected.