Abstract
Swelling of the right ankle and purpura on the bilateral lower extremities of a 6-year-old boy indicated a diagnosis of Henoch-Schönlein purpura (HSP). The patient was referred to our hospital because of severe abdominal pain that was unresponsive to prednisolone. Respiratory symptoms and pulmonary infiltrates on chest X-ray were absent upon admission. Methylprednisolone pulse therapy gradually improved the abdominal symptoms, but tachypnea developed, and insufficient aeration of the right lung was accompanied by a decline in percutaneous oxygen saturation from 99% to 90% and a rapid decrease in hemoglobin levels from 11.7 to 7.6 g/dL. Chest X-rays and high-resolution computed tomography scans showed widespread consolidation and patchy opacities predominantly in the right lung fields, suggesting acute pulmonary hemorrhage. Intravenous cyclosporin A (CyA) gradually resolved the pulmonary hemorrhage and respiratory insufficiency. Pulmonary hemorrhage, as a complication of HSP, is extremely rare and sometimes fatal. Aggressive steroid and immunosuppressive treatment is required to address severe complications of HSP.
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Matsubayashi, R., Matsubayashi, T., Fujita, N. et al. Pulmonary hemorrhage associated with Henoch-Schönlein purpura in a child. Clin Rheumatol 27, 803–805 (2008). https://doi.org/10.1007/s10067-007-0832-6
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DOI: https://doi.org/10.1007/s10067-007-0832-6