A case of pulmonary hemorrhage in Henoch-Schönlein purpura accompanied by polyarteritis nodosa in an elderly man.

A 77-year-old male diagnosed as having Henoch-Schönlein purpura (HSP) died of acute respiratory and renal failure. Autopsy revealed necrotizing glomerulonephritis with IgA deposition in mesangium and capillary walls of glomeruli. The lungs showed leukocytoclastic vasculitis of the alveolar walls and immunohistochemically revealed IgA deposition and ultrastructurally electron-dense deposits in the capillary basement membrane and interstitium of the alveoli. Moreover, fibrinoid necrosis of small and medium-sized arteries were observed in the kidneys, bronchial arteries of the lungs, stomach and small intestine. We have concluded that this case may be diagnosed as polyangitis overlap syndrome in an elderly man consisting of HSP and polyarteritis nodosa (PN), and the pulmonary hemorrhage may be significantly relevant to the pulmonary lesions not in PN but in HSP.