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Wolfram syndrome is a rare monogenic cause of juvenile onset diabetes mellitus. It is a non-autoimmune, insulin-deficient state with concurrent or consequent optic atrophy. Here we depict the case of a 16-year-old young girl afflicted with this condition, who presented with parasuicide on a background of depressive disorder. The aetiology of this presentation was attributable to multiple physical ailments and a genetic predisposition conferred by the disease-causing mutation for which she tested positive. She was managed with intensive insulin therapy and specific psychotherapy. Her case highlights the importance of recognising and addressing these comorbidities associated with Wolfram syndrome, so as to curtail disastrous consequences.

A 17-year-old girl from a rural part of Uttar Pradesh in India presented with high-grade fever of 2-month duration along with fatigability and weight loss. She had no symptoms of cough, breathlessness, chest pain, headache, backache or multiple swellings over the body. The patient was asymptomatic earlier with no history of chronic cough, fever or haemoptysis. She does have history of contact with her elder brother currently suffering from active pulmonary tuberculosis infection and on antitubercular medications. On examination, the patient was febrile with oral temperature fluctuating from 102°F to 103°F, pulse rate 106/min, blood pressure 110/60 mm Hg and respiratory rate 20 breaths/min with 95% …