We describe the case of a female patient suffering since the childhood from T1DM and AHT and in therapy with insulin and L-tiroxine, who developed JIA during adolescence unresponsive to conventional therapy with Non Steroid Anti Inflammatory Drugs (NSAIDs) and Methotrexate (MTX) for which we started anti-TNF therapy. The gene discussed is INS; the disease is juvenile idiopathic arthritis.