Background: Henoch-Schönlein Purpura (HSP) is the most common vasculitis of childhood and affects the small blood vessels. Pulmonary involvement is a rare complication of HSP and diffuse alveolar hemorrhage (DAH) is the most frequent clinical presentation. Little is known about the real incidence of lung involvement during HSP in the pediatric age and about its diagnosis, management and outcome. Methods: In order to discuss the main clinical findings and the diagnosis and management of lung involvement in children with HSP, we performed a review of the literature of the last 40 years. Results: We identified 23 pediatric cases of HSP with lung involvement. DAH was the most frequent clinical presentation of the disease. Although it can be identified by chest x-ray (CXR), bronchoalveolar lavage (BAL) is the gold standard for diagnosis. Pulse methylprednisolone is the first-line of therapy in children with DAH. An immunosuppressive regimen consisting of cyclophosphamide or azathioprine plus corticosteroids is required when respiratory failure occurs. Four of the twenty-three patients died, while 18 children had a resolution of the pulmonary involvement. Conclusions: DAH is a life-threatening complication of HSP. Prompt diagnosis and adequate treatment are essential in order to achieve the best outcome.
Henoch-Schönlein Purpura in children: Not only kidney but also lung / G.M. Di Pietro, M.L. Castellazzi, A. Mastrangelo, G. Montini, P. Marchisio, C. Tagliabue. - In: PEDIATRIC RHEUMATOLOGY ONLINE JOURNAL. - ISSN 1546-0096. - 17:1(2019 Nov), pp. 75.1-75.10.
|Titolo:||Henoch-Schönlein Purpura in children: Not only kidney but also lung|
|Parole Chiave:||Children; Diffuse alveolar hemorrhage; Henoch-Schönlein Purpura; IgA Vasculitis; Pulmonary involvement|
|Settore Scientifico Disciplinare:||Settore MED/38 - Pediatria Generale e Specialistica|
|Data di pubblicazione:||nov-2019|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1186/s12969-019-0381-y|
|Appare nelle tipologie:||01 - Articolo su periodico|
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