We describe a 25-year-old male with juvenile onset diabetes mellitus who developed severe pseudomembranous enterocolitis with intractable diarrhea for which he was maintained on total parenteral nutrition. Subsequently, he developed clinical signs and typical radiological manifestations of hypertrophic osteoarthropathy (HOA) associated with hemolytic anemia, proteinuria and immunoglobulin deficiency. Immune complexes were not detected in either sera and synovial fluid.

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