Excerpt
To the Editor:
We describe an additional patient with juvenile idiopathic arthritis (JIA) who developed a malignancy to augment the case series in the current issue of The Journal1. Our patient was diagnosed with polyarticular JIA at the age of 14 years (rheumatoid factor, antinuclear antibodies, and HLA-B27 negative). She was treated with nonsteroidal antiinflammatory drugs and methotrexate (MTX), eventually at a dose of 25 mg/week, given subcutaneously. Her arthritis improved, but radiographs showed new erosions at the metacarpophalangeal joints; she had difficulty tolerating MTX because of nausea, and at 17 years 3 months of age, etanercept was started at…
