Ulcerative colitis in a renal transplant patient with previous Goodpasture disease

A renal transplant was performed in a 6-year-old boy who developed end stage renal disease (ESRD) after presenting with antiglomerular basement membrane (anti-GBM) disease. At 10 years of age he developed ulcerative colitis while being immunosuppressed with cyclosporin, prednisone, and azothioprine. He had a pan colectomy, and at 14 years has no symptoms of ulcerative colitis 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 these two autoimmune diseases, we propose that the patient's homozygosity at HLA DR2 may have predisposed him to bath.