Combined Corticosteroid and Azathioprine Therapy

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Abstract
Therapeutic attempts to modify the outcome of Wegener's granulomatosis with renal involvement have generally been disappointing, although remissions have been reported with the use of corticosteroids,1,2 azathioprine (Imuran),3 and mechlorethamine hydrochloride.4 The purpose of this report is to document the course of two patients treated with combined corticosteroid-azathioprine therapy. Both have undergone clinical remissions lasting for 12 to 17 months, respectively, with serial measurements of glomerular filtration rate demonstrating significant improvement of renal function. Electron microscopic appearance of the renal lesions is also described. Patient Summaries Patient 1. —Patient 1 is a 48-year-old single, white woman bookkeeper. In December 1962 when completely asymptomatic, she was informed that a portable chest x-ray film was "abnormal." In February 1963 she developed severe unilateral otitis media which was thought to be secondary to staphylococcal infection. In August 1963 the patient noted illdefined discomfort in the lower extremities which was made

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