Pulmonary hemorrhage associated with Henoch-Schönlein purpura in a child.

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.

• Authors: Rie Matsubayashi, Tadashi Matsubayashi, Naoya Fujita, Takuya Yokota, Yoichiro Ohro, Hideo Enoki
• Journal: Clinical rheumatology (Clin Rheumatol) Vol. 27 Issue 6 Pg. 803-5 (Jun 2008) ISSN: 0770-3198 [Print] Germany
• PMID: 18196442 (Publication Type: Case Reports, Journal Article)

Chemical References

• Glucocorticoids
• Methylprednisolone

Topics

• Acute Disease
• Child
• Glucocorticoids (administration & dosage)
• Hemorrhage (diagnostic imaging, etiology)
• Humans
• IgA Vasculitis (complications, diagnostic imaging, drug therapy)
• Lung Diseases (diagnostic imaging, etiology)
• Male
• Methylprednisolone (administration & dosage)
• Pulmonary Circulation
• Pulse Therapy, Drug
• Tomography, X-Ray Computed