The differential diagnosis here is broad and should include vasculitis. Could the symptoms of temporal pain, vision changes, elevated erythrocyte sedimentation rate, weight loss, fevers and perhaps certain others have been GCA? Could Hitler’s known amphetamine use have contributed?42 We suspect the answers are “no” and “no,” but the conjecture is not unreasonable. This illustrates the fun of speculating about possible illnesses in historical figures, but also the limitations of the exercise (a comment that generalizes to the entirety of this piece).
What if … Hitler did have giant cell arteritis and could have been treated? How different might that era have been?
Autoimmune Diseases in the White House: Possible Axial Spondyloarthropathy, Autoimmune Polyendocrinopathy Type 2, John F. Kennedy & Presidential Decision Making
John F. Kennedy was our youngest president, 43 years old when he took office. We present him with another president who had autoimmune disease, although his place in history could have been with those having spondyloarthritis (or issues of pain management).
For many years the president’s medical records were secret.44,45 Kennedy was born May 29, 1917. He had a sister with Addison’s disease.46 In 1931, he experienced chronic abdominal symptoms. He also had joint pains, and inflammatory bowel disease was suggested.44,46 In 1934–35, Kennedy had lymphopenia.45 Back pain started in adolescence and progressed in the setting of multiple sports injuries.46,47 He underwent several operations for lumbosacral instability; imaging documented alignment and fusion at L5–S1.47 A clear cause for this was not identified, and he later used crutches.44,47
In 1940, a systolic blood pressure of 80 mmHg was recorded. Kennedy had gastrointestinal symptoms then, and chronic urethritis, for which he took antibiotics.45 He also experienced episodes of syncope and exhaustion; during a trip to England in September 1947, he was diagnosed with adrenal crisis, returned home and was hospitalized in Boston, treated with desoxycorticosterone acetate and cortisone 25.48 It was reported he also suffered from complications of malaria.48
In 1954, Kennedy had his second back operation and was reported as Case 3 in a journal outlining management of adrenal disease in the perioperative period.47,48 Unfortunately, his procedure was complicated by severe wound infections, shock and near death, and he remained hospitalized for several months.44,47 In 1955, he was again hospitalized and started on levothyroxine for treatment of hypothyroidism. Of interest, spinal imaging done in 1957 demonstrated inflammation at the right sacroiliac joint.47 Due to the simultaneous diagnosis of hypoadrenalism and hypothyroidism, Kennedy was considered to have had autoimmune polyendocrine syndrome type 2.48
