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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.1The 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

ANURIA is a rare complication of retrograde pyelography. Early reports considered the mechanism "reflex." 1 Bilateral ureteral obstruction has been demonstrated as the cause in a number of cases. 2,3 This report describes a case in which bilateral ureteral obstruction was not present and suggests another pathogenesis for this complication: intrarenal obstructive nephropathy. Report of Case A 41-year-old man (No. 238301) was in good health until December 1964 when he noted the gradual onset of edema of the ankles, hands, and face. Urinalysis revealed 4+ protein and 3 to 5 red blood cells (RBC) per high power field and an occasional RBC cast. Urine protein excretion was 5 gm/24 hr and an intravenous pyelogram was normal. He was treated with prednisone, 60 mg daily, for at least six weeks without either clinical or laboratory improvement. On May 21, 1965, the patient was admitted to another hospital. Proteinuria and microscopic hematuria