Clinical Analysis of Scrotal Involvement in Childhood Henoch-Schonlein Purpura / 소아과

PURPOSE: Henoch-Schonlein purpura(HSP) is a systemic vasculitis affecting predominantly skin, the gastrointestinal tract, the joints and kidneys. Because the scrotal manifestations including swelling and pain (or tenderness) are known to be uncommon in male HSP patients, there has been a little mention of them in the studies of HSP. Therefore, we investigated the clinical and laboratory features of HSP children with scrotal involvement. METHODS: We retrospectively reviewed the clinical and laboratory data of 115 male patients with HSP who had visited Chungbuk National University Hospital in the last 12 years. We evaluated the risk factors for scrotal involvement, and the relation between scrotal involvement and other clinical features, including renal manifestations in HSP. RESULTS: The incidence of scrotal involvement was 21.7%(25/115). Scrotal symptoms manifested as swelling in 88.0% and pain(or tenderness) in 68.0% of HSP patients with scrotal involvement. Of various manifestations, neurologic symptoms and localized edema were more frequent in the scrotal- involved group compared with non-involved group. Of immunologic indices, serum C3 level of scrotal involvement group was significantly higher than that of the other. However, there was no difference in the improvement of scrotal symptoms according to therapy, and scrotal involvement had no correlation with renal involvement during the acute to chronic phases. CONCLUSION: We found that neurologic symptoms, localized edema and high serum C3 level show a significant relation with scrotal involvement in male HSP patients. Because scrotal involvement in male HSP patients is not rare, about 21.7%, pediatricians and urologists should search for the presence of purpura in childhood acute scrotum.

Relation between Renal and Scrotal Involvememt in Henoch-Sch nlein Purpura

PURPOSE: Although Henoch-Sch nlein purpura(HSP) has been described in detail, there is a paucity of information describing scrotal involvement and risk factors for renal involvement. This study was performed to evaluate the incidence of scrotal involvement and the relationship between renal and nonrenal involvement, including scrotal involvement. METHODS: We retrospectively reviewed medical records of 164 male children who were diagnosed as HSP at the Department of Pediatrics, Korea University Guro Hospital between January 1985 and December 1997. RESULTS: The incidence of scrotal involvement was 13.4%(22/164), and the mean age of the group of scrotal involvement was significantly younger(5.6+/-1.9 year) than that of the others (P<0.05). One patient was initially seen with scrotal involvement without any other symptoms, another patient, who presented with acute scrotal pain and swelling, turned out to have testicular torsion through laparotomy. Those with scrotal and gastrointestinal symptoms were more likely to be related to renal involvement at acute stage, but there was no statistical difference. Those with scrotal symptoms at acute stage developed nephritis more frequently after 6 months(P<0.05). CONCLUSION: Those with scrotal symptoms at acute stage of HSP should be followed up for at least 6 months.