Abstract
Henoch-Schönlein purpura (HSP) is a common vasculitic syndrome in children who, in most cases, achieve complete recovery. Occasionally, however, patients develop nephritis or nephrotic syndrome with renal failure, or develop significant gastrointestinal bleeding. Pulmonary hemorrhage, found mostly in adolescents and adults, and with a high mortality rate, has been reported only in a few prepubertal children, with a slightly better outcome. A 9-year-old-girl with HSP, renal failure, and nephrotic syndrome developed severe bilateral pulmonary hemorrhage. After an unsuccessful trial of glucocorticoid therapy, she showed an excellent response to cytotoxic therapy.