Pulmonary haemorrhage in a 6-year-old boy with Henoch-Schönlein purpura

Clin Rheumatol. 2001;20(4):293-6. doi: 10.1007/pl00011205.

Abstract

Henoch-Schönlein purpura (HSP) is the most common vasculitis in children. It is a multisystemic disease but pulmonary haemorrhage is extremely rare. We present the case of a 6-year-old boy with Henoch-Schönlein purpura, pulmonary haemorrhage and severe renal involvement. The patient responded to a combination of intravenous methylprednisolone and cyclophosphamide. A review of the literature revealed that young age may be a good prognostic sign and that immunosuppressive drugs and supportive management are essential in the treatment. Renal biopsy is helpful in the differential diagnosis of HSP-mimicking pulmonary vasculitic syndromes. Combining cyclophosphamide with glucocorticoids may improve the outcome in severe HSP cases with pulmonary haemorrhage.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Child
  • Cyclophosphamide / administration & dosage*
  • Drug Therapy, Combination
  • Follow-Up Studies
  • Hemorrhage / diagnosis
  • Hemorrhage / drug therapy
  • Hemorrhage / etiology*
  • Humans
  • Infusions, Intravenous
  • Lung Diseases / diagnosis
  • Lung Diseases / drug therapy
  • Lung Diseases / etiology*
  • Male
  • Methylprednisolone / administration & dosage*
  • Purpura, Schoenlein-Henoch / complications*
  • Purpura, Schoenlein-Henoch / diagnosis
  • Purpura, Schoenlein-Henoch / drug therapy*
  • Renal Dialysis
  • Renal Insufficiency / diagnosis
  • Renal Insufficiency / etiology*
  • Renal Insufficiency / therapy
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Cyclophosphamide
  • Methylprednisolone