Henoch-Schönlein purpura and pulmonary hemorrhage : a report and literature review

Pulmonary hemorrhage, a rare complication of Henoch-Schönlein purpura (HSP) reported primarily in adults and adolescents, is associated with significant mortality. Although it has been suggested that pulmonary hemorrhage also occurs in children with HSP, the few cases reported lack a clear differentiation from pauci-immune vasculitis. We report a prepubertal child with HSP, pulmonary hemorrhage, and immunofluorescence-documented IgA deposits on renal biopsy. Aggressive supportive management and steroid therapy led to successful recovery. A review of the current literature is presented. Because other conditions clinically mimic HSP, appropriate serological studies and a kidney biopsy to confirm the diagnosis should be performed in severely affected patients with renal disease.