Hemothorax associated with Henoch–Schönlein purpura

Abstract

Hemothorax is an extremely rare complication of Henoch–Schönlein purpura. In this report, we encountered a 9-year-old girl who suffered from nonthrombocytopenic purpura on her eyelids, buttocks, and lower limbs with hypertension, heme-positive stools, high serum immunoglobulin A, and low serum complement component 3. Her skin biopsy revealed leukocytoclastic vasculitis with immunoglobulin A deposition. In addition, physical examination showed dullness on percussion and quiet breath sounds on the left chest. Chest X-ray showed a large pleural effusion on the left hemithorax. Computed tomography of her thorax revealed massive left-sided hemothorax with mediastinal shift to the right side. Most critically, pleural fluid evacuated by the chest tube was bloody. The patient was diagnosed as having Henoch–Schönlein purpura in combination with hemothorax, and treated with pulse methylprednisolone followed by oral corticosteroids plus cyclophosphamide. Fortunately, we achieved excellent outcomes and the patient recovered gradually within a week.

Keywords

• hemothorax
• Henoch–Schönlein purpura
• immunoglobulin A
• methylprednisolone
• pleural fluid