Case for diagnosis

Januário, Gustavo; Santiago, Felicidade

doi:10.1590/s0365-05962012000100026

Cited by 2 publications

(4 citation statements)

References 7 publications

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“…In the case review, we found that 10 (48%) patients had gastrointestinal involvement (eg, abdominal pain or vomiting). 7 , 8 , 11 , 12 , 15 , 17 , 19 , 25 Four (19%) patients had fever, 6 , 16 , 22 , 26 9 (42%) patients had joint involvement, 7 , 13 – 16 , 21 – 23 , 25 2 (9%) patients had penis involvement, 7 , 8 and hematuria was found in 2 (9%) cases. 11 , 12 Regarding the onset of HSP and scrotal involvement, 14 cases of scrotal involvement manifested after the onset of HSP (67%), 7 , 8 , 12 , 15 , 17 – 20 , 22 , 23 , 25 , 26 5 cases were before the onset of HSP (24%), 11 , 13 , 14 , 16 , 24 and 2 cases occurred simultaneously with HSP (9%).…”

Section: Clinical Observations Of Scrotal Involvementmentioning

confidence: 99%

“…11,12 Regarding the onset of HSP and scrotal involvement, 14 cases of scrotal involvement manifested after the onset of HSP (67%), 7,8,12,15,[17][18][19][20]22,23,25,26 5 cases were before the onset of HSP (24%), 11,13,14,16,24 and 2 cases occurred simultaneously with HSP (9%). 5,21 It shows that scrotal involvement can occur at any point in relation to the diagnosis of HSP. How scrotal, joint, renal, and gastrointestinal involvement impact each other is unclear and needs further investigation.…”

Section: Clinical Observations Of Scrotal Involvementmentioning

confidence: 99%

“…Among the 21 patients with scrotal involvement, the imaging studies performed that 14 patients showed epididymitis 7,8,11,12,[18][19][20]23,25 ; 1 patient had orchitis 24 and patients had epididymo-orchitis. 6,13,17,[21][22][23] Surgical exploration revealed that epididymal and scrotal hyperemia, and epididymis without torsion occurred in 4 patients. 12,13,25 One patient had a testicular infarction due to an early misdiagnosis of epididymitis and conservative treatment.…”

Section: Laboratory Analysis According To Scrotal Involvementmentioning

confidence: 99%

“…Four (19%) patients had fever,6,16,22,26 9 (42%) patients had joint involvement,7,13–16,21–23,25 2 (9%) patients had penis involvement,7,8 and hematuria was found in 2 (9%) cases 11,12. Regarding the onset of HSP and scrotal involvement, 14 cases of scrotal involvement manifested after the onset of HSP (67%),7,8,12,15,17–20,22,23,25,26 5 cases were before the onset of HSP (24%),11,13,14,16,24 and 2 cases occurred simultaneously with HSP (9%) 5,21. It shows that scrotal involvement can occur at any point in relation to the diagnosis of HSP.…”

Section: Clinical Observations Of Scrotal Involvementmentioning

confidence: 99%

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Henoch-Schönlein Purpura With Scrotal Involvement: A Case Report and Literature Review

Zhang

Chen

et al. 2021

Journal of Pediatric Hematology/Oncology

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Henoch-Schönlein purpura (HSP) is the most common vasculitis of childhood and affects the small blood vessels, leading to arthritis, abdominal pain, and renal involvement. However, scrotal involvement is a rare complication of HSP and scrotal pain. Swelling is the most frequent clinical presentation and can be easily confused with testicular torsion. If not treated in time, the scrotal inflammation will result in irreversible testicular necrosis. We report a 6-year-old male with HSP and scrotal involvement, characterized by swelling and pain on the left side of the scrotum, rashes on both lower extremities, and epididymitis. He was treated with conservative care, corticosteroids, and antibiotic therapy. We were able to avoid surgical intervention. On the 10 days of treatment, he recovered sufficiently well and was discharged. We have reviewed the literature related to HSP with scrotal involvement, identified 21 cases, and revealed that steroid therapy and/or antibiotics are the first-line of therapy in children with scrotal involvement. Vasculitis in the scrotum may predispose to testicular torsion, which is a complication that should not be overlooked. Clinicians should be aware of the atypical types of HSP. Timely diagnosis and appropriate treatment are essential for achieving the best results.

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Section: Clinical Observations Of Scrotal Involvementmentioning

confidence: 99%

Section: Clinical Observations Of Scrotal Involvementmentioning

confidence: 99%

Section: Laboratory Analysis According To Scrotal Involvementmentioning

confidence: 99%

Section: Clinical Observations Of Scrotal Involvementmentioning

confidence: 99%

See 2 more Smart Citations

Henoch-Schönlein Purpura With Scrotal Involvement: A Case Report and Literature Review

Zhang

Chen

et al. 2021

Journal of Pediatric Hematology/Oncology

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External Male Genitalia in Henoch–Schönlein Syndrome: A Systematic Review

Montorfani-Janett

Montorfani²,

Lavagno³

et al. 2022

Children

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The external genitalia are notoriously implicated in every fifth male with Henoch–Schönlein syndrome. Nonetheless, the underlying conditions are poorly categorized. To characterize the involvement of the external male genitalia in this vasculitis, we performed a systematic review of the literature. For the final analysis, we selected 85 reports published between 1972 and 2022, which reported on 114 Henoch–Schönlein cases (≤ 18 years, N = 104) with a penile (N = 18), a scrotal (N = 77), or both a penile and a scrotal (N = 19) involvement. The genital involvement mostly appeared concurrently with or after the cutaneous features of Henoch–Schönlein syndrome, while it preceded the presentation of Henoch–Schönlein syndrome in 10 cases. Patients with penile involvement (N = 37) presented with swelling (N = 26), erythema (N = 23), and purpuric rash (N = 15). Most patients were otherwise asymptomatic except for transient micturition disorders (N = 2) or priapism (N = 2). Patients with scrotal involvement (N = 96) presented with pain (N = 85), swelling (N = 79), erythema (N = 42), or scrotal purpura (N = 22). The following scrotal structures were often involved: scrotal skin (N = 83), epididymis (N = 49), and testes (N = 39). An ischemic testicular damage was noted in nine patients (four with torsion and five without). The scrotal skin involvement was mostly bilateral, while that of the epididymis and testis were mostly (p < 0.0001) unilateral (with a significant predilection for the left side). In conclusion, this analysis allows for better categorization of the involvement of external male genitalia in Henoch–Schönlein vasculitis. Scrotal involvement can result from skin inflammation, epididymitis, orchitis, or testicular ischemia.

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Case for diagnosis

Abstract: Henoch-Schönlein Purpura (HSP) is the most common vasculitis in children. In the absence of significant renal disease it has an excellent prognosis. In the case described, HSP initially presented together with orchitis. This infrequent event required the exclusion of testicular torsion.

Cited by 2 publications

References 7 publications

Henoch-Schönlein Purpura With Scrotal Involvement: A Case Report and Literature Review

Henoch-Schönlein Purpura With Scrotal Involvement: A Case Report and Literature Review

External Male Genitalia in Henoch–Schönlein Syndrome: A Systematic Review

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