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Twenty-two patients with Crohn's disease were treated with azathioprine (2 mg. per kg. per day) or placebo in a double-blind controlled trial lasting 24 weeks. Twelve acutely ill patients received a course of prednisolone adequate to ensure early remission (group I), and ten outpatients were already in a remission induced and maintained by prednisolone (group II). Ten of eleven patients on azathioprine remained in remission and completed the trial, whereas eight of eleven receiving placebo were withdrawn early because of relapse. The mean interval between discontinuation of prednisolone and completion of or withdrawal from the trial was 10·7 weeks for patients on azathioprine and 4·0 weeks for those on placebo. Clinical estimates of improvement and continued remission in azathioprine-treated patients of groups I and II were confirmed by " disease-activity scores " compiled from clinical and laboratory data.

In 6 patients anticoagulated with warfarin, nicoumalone, or phenindione the addition of cimetidine prolonged the prothrombin-time (PT) by a mean of 12·6 s (range 5-23 s). In 7 volunteers taking daily subtherapeutic doses of warfarin the addition of cimetidine increased the PT from 19·4 to 22·9 s and the plasma-warfarin concentration from 0·96 to 1·76 μg/ml. Cimetidine reduced the single-dose clearance of warfarin and antipyrine. The basis of the interaction between cimetidine and oral anticoagulants is probably inhibition of drug metabolism. Care should be exercised in concomitant therapy.

Summary Kveim tests were done in forty-eight patients with Crohn’s disease. Of forty-five with definite or probable Crohn’s disease, twenty-three had a positive Kveim test. This finding could be explained: (1) By cross-reactivity between sarcoidosis and Crohn’s disease antigens; (2) By an aetiological agent common to the two diseases, or (3) By a property of the Kveim test material used in testing.

Specific inhibition of leucocyte migration in vitro by a sarcoid spleen suspension has been demonstrated in four out of ten patients with cœliac disease and sixteen out of seventeen with dermatitis herpetiformis. This finding provides additional evidence that reactivity to extracts of sarcoid tissue may occur in disorders of which the epithelioid granuloma is not a feature.

Kveim tests were done on 84 patients with definite, probable and doubtful Crohn's disease. Of the 74 with definite or probable disease, 38 (51%) had a positive Kveim test. Simultaneous Kveim tests with two different test suspensions have been done on 19 patients with histologically confirmed or clinically definite Crohn's disease; 11 had a positive Kveim test with both suspensions. It is concluded that these findings demonstrated a cross-reactivity between sarcoidosis and Crohn's disease, and raise the possibility that a common (or closely related) agent may be responsible for the two diseases.