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April 4, 1966

Goodpasture's Syndrome: Treatment Failure With Azathioprine

Author Affiliations

From the departments of medicine, surgery, and pathology, University of Colorado School of Medicine, Denver. Dr. Holman is a US Public Health Service Postdoctoral Fellow in Renal Disease.

JAMA. 1966;196(1):31-32. doi:10.1001/jama.1966.03100140085023

Goodpasture's syndrome remains a disease of undetermined etiology although the possibility of an immunologic basis has been raised. Immunosuppressive agents have been used late in the course of this disease without benefit.1 The purpose of this paper is to report the results of azathioprine (Imuran) therapy begun prior to the onset of renal insufficiency in a patient with classical Goodpasture's syndrome.

Report of a Case  This 20-year-old white man had been well until the first of Jan, 1965, when he suddenly began to cough bright red blood. He was admitted to another hospital where an x-ray film revealed pulmonary infiltrates (Fig 1). The hematocrit reading and analysis of the urine were reported as normal, but a value for blood urea nitrogen (BUN) was not determined. The patient improved spontaneously and after one week, the chest appeared normal on a radiograph.The patient had hemoptysis again on Feb 1, and