Ulcerative colitis in a renal transplant patient with previous Goodpasturedisease

A renal transplant was performed in a 6-year-old boy who developed end stag e renal disease (ESRD) after presenting with antiglomerular basement membra ne (anti-GBM) disease. At 10 years of age he developed ulcerative colitis w hile being immunosuppressed with cyclosporin, prednisone, and azothioprine. He had a pan colectomy, and at 14 years has no symptoms of ulcerative coli tis or anti-GEM disease. HLA typing revealed that he was homozygous for HLA DR2. The co-occurrence of anti-GEM disease and ulcerative colitis has not previously been described. Although there is no known common etiology for t hese two autoimmune diseases, we propose that the patient's homozygosity at HLA DR2 may have predisposed him to bath.