Recurrence of Wegener's granulomatosis after kidney transplantation. Successful re-induction of remission with cyclophosphamide.

A patient with Wegener's granulomatosis underwent successful kidney transplantation. After four years he had a recurrence of his disease while being maintained on azathiorpine. Substitution of cyclophosphamide for azathioprine resulted in a rapid remission of the Wegener's granulomatosis. Renal function has remained stable, and the patient has done well. As previous reports have suggested, it appears that cyclophosphamide is the immunosuppressive drug of choice in the treatment of Wegener's granulomatosis and that azathioprine is not as effective as cyclophosphamide in the treatment of this form of systemic vasculitis.