MiscellaneousPulmonary Hemorrhage Associated with Henoch-Schönlein Purpura in Pediatric Patients: Case Report and Review of the Literature
Section snippets
Methods
We present a previously unreported case of pediatric HSP with pulmonary hemorrhage. A PubMed (www.ncbi.nlm.nih.gov/pubmed) search of the literature (1966 to April 2010) was performed to identify all previously reported cases of pulmonary hemorrhage associated with HSP by using the terms Henoch-Schönlein purpura, pediatric, pulmonary hemorrhage, and pulmonary renal syndrome. We found 16 cases and summarized the reported symptoms, clinical findings, treatments, and outcomes.
Case Report
In March of 2009, an 11-year-old girl, who had HSP diagnosed by intermittent abdominal pain, skin rash, and small intestine biopsy when she was 4 years old, was referred to our emergency department due to intermittent abdominal pain and multiple purpura over her elbows and lower legs for the previous 3 days. She also had a mild cough without sputum, vomiting, anorexia, and general malaise. A physical examination indicated multiple purpura over her elbows and distal legs and bilateral coarse
General Characteristics, Clinical Manifestation, and Laboratory Findings
Based on our PubMed review, there were 16 previously reported pediatric cases of HSP associated with pulmonary hemorrhage since 1966. Table 1 shows the general characteristics, clinical features, and laboratory findings of these 16 patients and our patient (patient 17). Nine of these cases (53%) were male and the mean age at diagnosis of HSP with pulmonary hemorrhage was 10.5 years (range, 1.75-17 years). Pulmonary hemorrhage was the first manifestation of HSP in 15 patients (88%). All patients
Discussion
HSP is a small-vessel vasculitis, usually seen in children, that is characterized by purpura, arthralgia, gastrointestinal symptoms, and glomerulonephritis. The diagnosis of HSP in our patient is based on clinical findings and pathology including typical purpura, abdominal pain, and glomerulonephritis at this admission. A renal biopsy indicated IgA deposition, which was compatible with HSP. The results of autoimmune survey in our patient were all negative except p-ANCA, which is frequently
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The authors have no conflicts of interest to disclose.