Pulmonary haemorrhage in a 6-year-old boy with Henoch-Schonlein purpura

Henoch-Schonlein purpura (HSP) is the most common vasculitis in children. I t is a multisystemic disease but pulmonary haemorrhage is extremely rare. W e present the case of a 6-year-old boy with Henoch-Schonlein purpura, pulmo nary haemorrhage and severe renal involvement. The patient responded to a c ombination of intravenous methylprednisolone and cyclophosphamide. A review of the literature revealed that young age may be a good prognostic sign an d that immunosuppressive drugs and supportive management are essential in t he treatment. Renal biopsy is helpful in the differential diagnosis of HSP- mimicking pulmonary vasculitic syndromes. Combining cyclophosphamide with g lucocorticoids may improve the outcome in severe HSP cases with pulmonary h aemorrhage.