Sequential development of 2 connective tissue diseases in juvenile patients.

The sequential development of two connective tissue diseases in the same patient has been rarely reported. We describe 2 juvenile patients, a 15-year-old girl who, after having juvenile rheumatoid arthritis (JRA) for a 7-year period presented with clearly defined features of systemic lupus erythematosus with diffuse proliferative glomerulonephritis. The 2nd case, a 9-year-old boy developed erosive polyarticular JRA after having had a clear picture of dermatomyositis in infancy. In both cases there was a lengthy disease free period between the 2 diseases.