A patient with Henoch-Schönlein purpura and intra-alveolar haemorrhage
Abstract
NDT Plus (2008) 3: 167â170 doi: 10.1093/ndtplus/sfn015 Advance Access publication 3 March 2008 Teaching Point (Section Editor: A. Meyrier) A patient with Henoch-Sch¨ nlein purpura and intra-alveolar o haemorrhage Nigel D. Toussaint1 , Michael Desmond2 and Prue A. Hill3 1 Department of Nephrology, Monash Medical Centre, Clayton, Victoria, Australia, 2 Departments of Nephrology and 3 Anatomical Pathology, St. Vincentâs Hospital, Fitzroy, Victoria, Australia Keywords: Henoch-Sch¨ nlein purpura; pulmonary o haemorrhage; renal failure Background Henoch-Sch¨ nlein purpura (HSP) is a systemic vasculio tis predominantly occurring in prepubertal children and characterised by a purpuric rash on the lower extremities, arthralgia and abdominal pain. Renal involvement is not uncommon affecting between 20 and 80% of patients [1] and severe nephrotic syndrome or nephritis is frequently associated with significant renal disease, morbidity and mortality. Lung involvement, especially pulmonary haemorrhage, is rare and reported primarily in adolescents and adults and it carries significant mortality [2]. We report a case of an adult with severe HSP complicated by acute renal failure and pulmonary haemorrhage where aggressive supportive management, corticosteroids and cytotoxic therapy with cyclophosphamide provided life-saving treatment. We discuss the association between systemic HSP and lung involvement as well as options for treatment of