Remission in Goodpasture's syndrome: report of two patients treated by immunosuppression and review of the literature.

Two patients with Goodpasture's syndrome are reported. One showed an apparently spontaneous remission and has survived in good health for over five years since the onset of his illness; he was treated for part of this time with steroids and chlorambucil. The second patient failed to respond to steroids but appeared to improve rapidly from a moribund state on administration of azathioprine; he remains well, although in mild renal failure, over a year later. The management of 35 other patients reported to have survived this illness is reviewed. It appears that both the renal and pulmonary features of Goodpasture's syndrome may undergo spontaneous remission, and that the latter can sometimes be suppressed with steroid or immunosuppressant therapy. On four occasions the pulmonary manifestations of the disease have been arrested by nephrectomy.