Case reports of Henoch-Schönlein syndrome invariably note the presence of purpura at the time of the vasculitic syndrome. We document an unusual recurrence of Henoch-Schönlein syndrome in the absence of purpura. A 29-year-old man with a history of Henoch-Schönlein vasculitis with several typical purpuric recurrences was admitted with hemoptysis, pulmonary hemorrhage and no cutaneous lesions. Because he had not had purpura in 3 years, a broad differential diagnosis of hemoptysis was considered. A random skin biopsy showing intravascular immunoglobulin A and C3 deposition helped to confirm an apurpuric recurrence of Henoch-Schönlein vasculitis.
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