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

Vats, Kalyani; Vats, Abhay; Kim, Youngki; Dassenko, David; Sinaiko, Alan R.

doi:10.1007/s004670050652

Cited by 47 publications

(34 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is more common in children, with a reported incidence of 15 per 100,000. Pulmonary involvement in children is rare [2]. The reported pulmonary complications are impairment in diffusion capacity of the lungs and pulmonary haemorrhage [3].…”

Section: Discussionmentioning

confidence: 99%

A 47-year-old male with respiratory and renal failure

Jaiswal

Packham

Stevens

et al. 2005

Breathe

View full text Add to dashboard Cite

A 47-year-old male was admitted with a 5-day history of painful, red, swollen legs, and 48 hours of intermittent sweats and rigors. His only previous medical history was Perthe's disease of the right hip at the age of 8 years. He had no allergies and there was no family history. He was taking ampicillin at a dose of 500 mg t.d.s., as prescribed by his general practitioner. He had a temperature of 39°C on admission. Physical examination proved normal, apart from the area of skin over both ankles and the lower right leg, which was swollen, red, hot and tender.Initial investigations revealed leukocytosis of 15.9x10 -9 , neutrophils 11.7x10 -9 and a C-reactive protein level of 70.5 (normal range 0-10). Renal function and serum electrolytes were normal. Chest and ankle radiographs were also normal. Hip radiography revealed changes consistent with old Perthe's disease. Blood cultures were negative. A diagnosis of cellulitis was made by the admitting physicians, and the patient was prescribed intravenous benzylpenicillin and flucloxacillin.The leukocytosis resolved, but the patient continued to experience a fluctuating temperature. Nine days after admission, he developed non-specific abdominal pains. An ultrasound of the abdomen, kidneys and renal tract proved normal. The next day, he developed a rash on both legs (figure 1).

show abstract

Section: Discussionmentioning

confidence: 99%

A 47-year-old male with respiratory and renal failure

Jaiswal

Packham

Stevens

et al. 2005

Breathe

View full text Add to dashboard Cite

show abstract

“…In our unit more than 550 cases of HSP have been followed; 42% had renal involvement, but we had not encountered pulmonary haemorrhage with HSP in our series. Chaussain et al [19] showed impairment of lung diffusion capacity to be a common finding in children with HSP, but pulmonary haemorrhage in Henoch-Schönlein purpura is extremely rare: a total of 20 cases with an age range between 4.5 and 78 years have been reported [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. Eleven cases were seen in childhood (4.5-17 years).…”

Section: Discussionmentioning

confidence: 99%

“…It is the most common vasculitis seen in children. Although renal involvement is frequent (60%), pulmonary involvement is rare and it significantly increases the mortality [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. There are few reports regarding pulmonary haemorrhage in HSP.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Haemorrhage in a 6-Year-Old Boy with Henoch–Scho¨nlein Purpura

et al. 2001

View full text Add to dashboard Cite

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.

show abstract

“…Diffuse pulmonary hemorrhage has been increasingly recognized as a complication of the above-mentioned diseases (3). Pulmonary hemorrhage may occur in patients with HenochSchonlein purpura (4,5), but is quite uncommonin patients with Wegener's granulomatosis whodo not have granulomatous lesions in the lung. Therefore, her clinical presentations such as melena, colonic purpura and skin purpura with histology of leukocytoclastic vasculitis in combination with pulmonary hemorrhage should be interpreted as Henoch-Schonlein purpura.…”

Section: Case Reportmentioning

confidence: 99%

A Patient with Wegener's Granulomatosis with Initial Clinical Presentations of Henoch-Schoenlein Purpura.

et al. 2001

View full text Add to dashboard Cite

The initial presentation of a patient with Wegener's granulomatosis was indistinguishable from that of HenochSchonlein purpura. The patient presented with skin purpura and pulmonary hemorrhage followed by purpura in the colon. The diagnosis of this patient at that time was Henoch-Schonlein purpura. With time, massive lesions in the sinus and those with cavities in the lung became apparent, and a specimen obtained from the sinus massive lesion was disclosed to be granulomatous inflammation. Retrospectively, the proteinase 3 antineutrophil cytoplasmic antibody turned out to be strongly positive in her stored serum from the time of the initial presentation.

show abstract

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

Cited by 47 publications

References 15 publications

A 47-year-old male with respiratory and renal failure

A 47-year-old male with respiratory and renal failure

Pulmonary Haemorrhage in a 6-Year-Old Boy with Henoch–Scho¨nlein Purpura

A Patient with Wegener's Granulomatosis with Initial Clinical Presentations of Henoch-Schoenlein Purpura.

Contact Info

Product

Resources

About