Skip to main content
Top
Published in: Pediatric Rheumatology 1/2020

01-12-2020 | IgA Vasculitis | Case Report

Recurrent Henoch-Schönlein Purpura with bullous rash and pulmonary nodules

Authors: Christopher Zheng, Julie Childers, Egla Rabinovich, Kristina Nazareth-Pidgeon

Published in: Pediatric Rheumatology | Issue 1/2020

Login to get access

Abstract

Background

Henoch-Schönlein purpura (HSP) is the most common vasculitis of childhood. It has a characteristic rash described as palpable purpura that most frequently affects the distal lower extremities and buttocks. HSP rarely presents with bullous rash nor pulmonary nodules.

Case presentation

We present a novel case of a 12-years-old female with recurrent pediatric HSP with a combination of the rare manifestations of bullous rash and pulmonary nodules. She initially presented with the bullous rash, chest pain, cough, and abdominal pain. Patient was successfully treated with intravenous pulse corticosteroids followed by a high dose oral corticosteroid taper, with resolution of the bullous rash and pulmonary nodules.

Conclusion

The rare manifestations of scarring bullous rash and pulmonary nodules can be presenting features of pediatric HSP, the combination of which has not been previously reported. The treatment of intravenous corticosteroid resolved patient’s abdominal symptoms, rash and pulmonary nodules.
Literature
1.
go back to reference Hetland LE, Susrud KS, Lindahl KH, Bygum A. Henoch-Schonlein Purpura: a literature review. Acta Derm Venereol. 2017;97(10):1160–6.CrossRef Hetland LE, Susrud KS, Lindahl KH, Bygum A. Henoch-Schonlein Purpura: a literature review. Acta Derm Venereol. 2017;97(10):1160–6.CrossRef
2.
go back to reference Lei WT, Tsai PL, Chu SH, Kao YH, Lin CY, Fang LC, et al. Incidence and risk factors for recurrent Henoch-Schonlein purpura in children from a 16-year nationwide database. Pediatr Rheumatol Online J. 2018;16(1):25.CrossRef Lei WT, Tsai PL, Chu SH, Kao YH, Lin CY, Fang LC, et al. Incidence and risk factors for recurrent Henoch-Schonlein purpura in children from a 16-year nationwide database. Pediatr Rheumatol Online J. 2018;16(1):25.CrossRef
3.
go back to reference Deng F, Lu L, Zhang Q, Hu B, Wang SJ, Huang N. Henoch-Schonlein purpura in childhood: treatment and prognosis. Analysis of 425 cases over a 5-year period. Clin Rheumatol. 2010;29(4):369–74.CrossRef Deng F, Lu L, Zhang Q, Hu B, Wang SJ, Huang N. Henoch-Schonlein purpura in childhood: treatment and prognosis. Analysis of 425 cases over a 5-year period. Clin Rheumatol. 2010;29(4):369–74.CrossRef
4.
go back to reference Trapani S, Mariotti P, Resti M, Nappini L, de Martino M, Falcini F. Severe hemorrhagic bullous lesions in Henoch Schonlein purpura: three pediatric cases and review of the literature. Rheumatol Int. 2010;30(10):1355–9.CrossRef Trapani S, Mariotti P, Resti M, Nappini L, de Martino M, Falcini F. Severe hemorrhagic bullous lesions in Henoch Schonlein purpura: three pediatric cases and review of the literature. Rheumatol Int. 2010;30(10):1355–9.CrossRef
5.
go back to reference Su HW, Chen CY, Chiou YH. Hemorrhagic bullous lesions in Henoch-Schonlein purpura: a case report and review of the literature. BMC Pediatr. 2018;18(1):157.CrossRef Su HW, Chen CY, Chiou YH. Hemorrhagic bullous lesions in Henoch-Schonlein purpura: a case report and review of the literature. BMC Pediatr. 2018;18(1):157.CrossRef
6.
go back to reference Rajagopala S, Shobha V, Devaraj U, D'Souza G, Garg I. Pulmonary hemorrhage in Henoch-Schonlein purpura: case report and systematic review of the english literature. Semin Arthritis Rheum. 2013;42(4):391–400.CrossRef Rajagopala S, Shobha V, Devaraj U, D'Souza G, Garg I. Pulmonary hemorrhage in Henoch-Schonlein purpura: case report and systematic review of the english literature. Semin Arthritis Rheum. 2013;42(4):391–400.CrossRef
7.
go back to reference Chen SY, Chang KC, Yu MC, Asueh S, Ou LS. Pulmonary hemorrhage associated with Henoch-Schonlein purpura in pediatric patients: case report and review of the literature. Semin Arthritis Rheum. 2011;41(2):305–12.CrossRef Chen SY, Chang KC, Yu MC, Asueh S, Ou LS. Pulmonary hemorrhage associated with Henoch-Schonlein purpura in pediatric patients: case report and review of the literature. Semin Arthritis Rheum. 2011;41(2):305–12.CrossRef
8.
go back to reference Di Pietro GM, Castellazzi ML, Mastrangelo A, Montini G, Marchisio P, Tagliabue C. Henoch-Schonlein Purpura in children: not only kidney but also lung. Pediatr Rheumatol Online J. 2019;17(1):75.CrossRef Di Pietro GM, Castellazzi ML, Mastrangelo A, Montini G, Marchisio P, Tagliabue C. Henoch-Schonlein Purpura in children: not only kidney but also lung. Pediatr Rheumatol Online J. 2019;17(1):75.CrossRef
9.
go back to reference Nadrous HF, Yu AC, Specks U, Ryu JH. Pulmonary involvement in Henoch-Schonlein purpura. Mayo Clin Proc. 2004;79(9):1151–7.PubMed Nadrous HF, Yu AC, Specks U, Ryu JH. Pulmonary involvement in Henoch-Schonlein purpura. Mayo Clin Proc. 2004;79(9):1151–7.PubMed
10.
go back to reference Grabska-Kobylecka I, Nowak D, Wlodarczyk A, Bialasiewicz P. No impairment of pulmonary function in children with Henoch-Schonlein purpura after 4-year follow-up. Clin Rheumatol. 2016;35(11):2847–50.CrossRef Grabska-Kobylecka I, Nowak D, Wlodarczyk A, Bialasiewicz P. No impairment of pulmonary function in children with Henoch-Schonlein purpura after 4-year follow-up. Clin Rheumatol. 2016;35(11):2847–50.CrossRef
11.
go back to reference Weiss PF, Feinstein JA, Luan X, Burnham JM, Feudtner C. Effects of corticosteroid on Henoch-Schonlein purpura: a systematic review. Pediatrics. 2007;120(5):1079–87.CrossRef Weiss PF, Feinstein JA, Luan X, Burnham JM, Feudtner C. Effects of corticosteroid on Henoch-Schonlein purpura: a systematic review. Pediatrics. 2007;120(5):1079–87.CrossRef
12.
go back to reference Kang HS, Chung HS, Kang KS, Han KH. High-dose methylprednisolone pulse therapy for treatment of refractory intestinal involvement caused by Henoch-Schonlein purpura: a case report. J Med Case Rep. 2015;9:65.CrossRef Kang HS, Chung HS, Kang KS, Han KH. High-dose methylprednisolone pulse therapy for treatment of refractory intestinal involvement caused by Henoch-Schonlein purpura: a case report. J Med Case Rep. 2015;9:65.CrossRef
13.
go back to reference Allali S, Fraitag S, Terrier B, Bodemer C, Chalumeau M. Efficacy of colchicine in a child with relapsing bullous Henoch-Schonlein purpura. Eur J Pediatr. 2016;175(1):147–9.CrossRef Allali S, Fraitag S, Terrier B, Bodemer C, Chalumeau M. Efficacy of colchicine in a child with relapsing bullous Henoch-Schonlein purpura. Eur J Pediatr. 2016;175(1):147–9.CrossRef
14.
go back to reference Kausar S, Yalamanchili A. Management of haemorrhagic bullous lesions in Henoch-Schonlein purpura: is there any consensus? J Dermatolog Treat. 2009;20(2):88–90.CrossRef Kausar S, Yalamanchili A. Management of haemorrhagic bullous lesions in Henoch-Schonlein purpura: is there any consensus? J Dermatolog Treat. 2009;20(2):88–90.CrossRef
Metadata
Title
Recurrent Henoch-Schönlein Purpura with bullous rash and pulmonary nodules
Authors
Christopher Zheng
Julie Childers
Egla Rabinovich
Kristina Nazareth-Pidgeon
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Pediatric Rheumatology / Issue 1/2020
Electronic ISSN: 1546-0096
DOI
https://doi.org/10.1186/s12969-020-00436-7

Other articles of this Issue 1/2020

Pediatric Rheumatology 1/2020 Go to the issue