Acute Scrotal Swelling in Henoch-Schonlein Purpura: Case Report and Review of the Literature

Abstract

Henoch-Schönlein purpura (HSP) is a systemic vasculitis characterized classically by purpura, arthritis and abdominal pain. Epididymitis/orchitis is rarely seen as a complication of HSP. Testicular or scrotal involvement has been reported in children with Henoch-Schonlein purpura and must be distinguished from testicular torsion. We report a case of a 5 year old boy diagnosed with Henoch-Schönlein purpura with acute scrotal swelling. He was managed successfully with conservative approach. The history, clinical examination findings and scrotal ultrasound evaluation should suffice to make the correct diagnosis and avoid surgery. Steroid treatment and/or antibiotics appeared to be effective for this condition.

Acute Idiopathic Scrotal Edema: Systematic Literature Review

“…In boys with Henoch-Schönlein syndrome and acute hemorrhagic edema, two common pediatric vasculitides, the prevalence of acute scrotal swelling and thickening ranges from 5 to 25%. [41][42][43] Rarely, genital manifestations are the presenting finding. The features of acute idiopathic scrotal edema strongly resemble the scrotal involvement in the mentioned vasculitides.…”

“…Furthermore, Doppler studies disclose thickening, pronounced hypervascularity, and a positive fountain sign of the scrotal sac also in these vasculitides. [41][42][43] However, besides the characteristic cutaneous rash, the abdominal, articular, or renal involvement, Henoch-Schönlein syndrome and acute idiopathic scrotal edema differ about the presence of an infectious trigger and the testicular and epididymal swelling, which are frequent in Henoch-Schönlein syndrome and acute hemorrhagic edema. [41][42][43] The main limitation of this analysis results from the fact that most reports focus more on the differentiation of acute idiopathic scrotal edema from further causes of acute scrotum than on its management and course.…”

Unusual presentation of Henöch-Schonlein purpura

“…Scrotal symptoms of HSP mimicking testicular torsion are often a clinical conundrum 6. There are several cases reported of paediatric patients presenting with an acute scrotum due to HSP undergoing scrotal exploration for presumed torsion 7.…”

Ураження Суглобів При Пурпурі Шенлайна-Геноха

“…Су-ставной синдром даже входит в диагностические кри-терии ПШГ [11]. В целом поражение суставов (обыч-но коленных, голеностопных, лучезапястных) наблю-дается у 60-80 % от числа больных ПШГ, чаще разви-вается у взрослых и сочетается с миалгиями, а характер артрита у пациентов с дебютом заболевания в детском возрасте пока не исследован [1,12].…”