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Methotrexate and its effect on the anti-GAD titre in two patients with rheumatoid arthritis and diabetes mellitus
  1. A W van Deutekom1,
  2. M T Nurmohamed2,3,
  3. M J L Peters2,3,
  4. I C van Eijk2,
  5. B A C Dijkmans2,3,
  6. D Hamann4,
  7. R J Heine1,
  8. S Simsek1
  1. 1
    Department of Endocrinology/Diabetes Centre, VU University Medical Centre, Amsterdam, The Netherlands
  2. 2
    Department of Rheumatology, Jan van Breemen Institute, Amsterdam, The Netherlands
  3. 3
    Department of Rheumatology, VU University Medical Centre, Amsterdam, The Netherlands
  4. 4
    Sanquin Diagnostic Services at CLB, Department of Autoimmune Diseases, Amsterdam, The Netherlands
  1. Dr S Simsek, Department of Endocrinology/Diabetes Centre, VU University Medical Centre, PO Box 7057, 1007 MB, Boelelaan 1117, Amsterdam, The Netherlands; Simsek{at}vumc.nl

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Methotrexate (MTX) is the anchor drug in treatment of patients with rheumatoid arthritis (RA)1 2 and may reduce levels of rheumatoid factor (RF).3 4 Moreover, treatment of patients with RA with biological agents—that is, tumour necrosis factor α (TNFα) antagonist, is presently combined with MTX to reduce the formation of antibodies against the biological agents.

We describe two patients with known latent autoimmune diabetes of the adult and concomitant RA who showed a marked decline in anti-glutamic acid decarboxylase (GAD) titres after receiving MTX treatment.

The first case is a 68-year-old woman who has had anti-GAD positive diabetes since the age of 47, which was poorly controlled, without hypertension and a body mass …

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