Testicular Torsion Associated with Henoch-Schönlein Purpura

Kajitani, Sayuri; Miyamoto, Manabu; Tokura, Yuumi; Mizuno, Tomoya; Kambara, Tsunehito; Ichikawa, Go; Yoshihara, Shigemi

doi:10.1016/j.jpeds.2021.12.001

Cited by 3 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The diagnosis of ischemic testicular damage without torsion [ 32 , 54 , 78 , 79 , 81 ] was made in five cases (5, 8, 11, 12 and 24 years of age), and an orchidectomy was performed in four of the five cases [ 32 , 54 , 78 , 79 ]. The diagnosis of testicular torsion [ 27 , 40 , 76 , 83 ] was made in four cases (2, 4, 5, and 6 years of age); a testicular detorsion was performed in all of them, and was immediately followed by a normal testicular perfusion [ 27 , 40 , 76 , 83 ].…”

Section: Resultsmentioning

confidence: 99%

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

Montorfani-Janett

Montorfani²,

Lavagno³

et al. 2022

Children

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

confidence: 99%

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

Montorfani-Janett

Montorfani²,

Lavagno³

et al. 2022

Children

View full text Add to dashboard Cite

show abstract

“…Only one patient with IgAV combined with testicular torsion has been reported (9). Ma et al (26) reviewed the cases of 21 patients with IgAV with scrotal involvement published between 1986 and 2020, including five who underwent surgical exploration.…”

Section: Discussionmentioning

confidence: 99%

“…Some patients exhibit enlargement of the testes and/or epididymis and increased blood flow on ultrasound ( 6 – 8 ). Rarely, patients have symptoms mimicking testicular torsion, requiring surgical exploration ( 9 – 11 ). Zhao et al .…”

Section: Introductionmentioning

confidence: 99%

“…Some patients exhibit enlargement of the testes and/or epididymis and increased blood flow on ultrasound (6)(7)(8). Rarely, patients have symptoms mimicking testicular torsion, requiring surgical exploration (9)(10)(11). Zhao et al (12) reported the deposition of immune complexes containing IgA in affected testicular tissue, suggesting that the testis is a target organ for IgAV.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Immunoglobulin a vasculitis with testicular/epididymal involvement in children: A retrospective study of a ten-year period

Zhao

Wen

et al. 2023

Front. Pediatr.

View full text Add to dashboard Cite

The clinical characteristics and risk factors for testicular/epididymal involvement in 73 children with immunoglobulin A vasculitis (IgAV) who were admitted to our hospital between January 2012 and November 2022 were reviewed. The demographic data, laboratory parameters, and follow-up data of the patients were compared to those of 146 males without testicular/epididymal involvement. A logistic regression analysis was performed to determine the variables associated with testicular/epididymal involvement. The prevalence of testicular/epididymal involvement among male patients with IgAV was 1.3% (73/5,556). Increased blood flow in the testes and/or epididymis on ultrasound was found in 71 patients. The remaining two patients underwent surgical exploration for loss or reduction of testicular blood flow. One patient underwent orchiectomy for intraoperative confirmation of complete right testicular infarction. Pathological findings revealed IgA immune complex deposition in the testis. Patient age (odds ratio [OR] = 0.792; 95% confidence interval [CI]: 0.682–0.919, p = 0.002), platelet count (OR = 1.011; 95% CI: 1.002–1.020, p = 0.013), and immunoglobulin M (IgM) levels (OR = 0.236; 95% CI: 0.091–0.608, p = 0.003) were strongly associated with the occurrence of testicular/epididymal involvement in IgAV. Therefore, young age, increased platelet count, and low IgM levels in patients with IgAV are potential risk factors for testicular/epididymal involvement. Doppler ultrasound can help differentiate IgAV from acute scrotum. Most patients with testicular/epididymal involvement have good prognoses, although serious complications such as testicular infarction may occur.

show abstract

“…The vast majority of the cases have been reported in men and involved the scrotum, penis, epididymis, testicles, and spermatic cord. Cases involving testicular blood vessels may be complicated with epididymitis or epididymo-orchitis ( 7 , 8 , 10 ), testicular torsion ( 14 ), and spermatic vein thrombosis ( 9 , 15 ), all of which are risk factors for testicular necrosis that can lead to testicular ischemia and necrosis if not timely treated.…”

Section: Discussionmentioning

confidence: 99%

Testicular ischemia associated with IgA vasculitis in a child: a case report and literature review

2023

View full text Add to dashboard Cite

Testicular necrosis is a rare and severe complication of immunoglobulin A (IgA) vasculitis (IgAV). Herein, We report a case of a 10-year-old boy who was admitted to the hospital due to skin purpura and intermittent abdominal pain for 10 days and bilateral testicular pain for 2 days. Scrotal ultrasonography indicated right testicle ischemia, right epididymo-orchitis, and bilateral hydrocele of the testis. Scrotal surgical exploration revealed significant swelling and darkening of the right testicle. Conservative treatment led to improvement in his condition, and he was discharged. During 3 months of follow-up, there was no recurrence of skin purpura or pain, and the urine tests were normal. Color ultrasound indicated only partial blood flow signal to the right testicle tissue, which was slightly smaller than the left testicle. This case highlights the need for continuous attention from clinicians to the signs and symptoms of the reproductive system during the diagnosis and treatment of IgAV. Continuous monitoring with ultrasound can aid in early detection, diagnosis, and treatment of reproductive system lesions of IgA vasculitis.

show abstract

Testicular Torsion Associated with Henoch-Schönlein Purpura

Cited by 3 publications

References 5 publications

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

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

Immunoglobulin a vasculitis with testicular/epididymal involvement in children: A retrospective study of a ten-year period

Testicular ischemia associated with IgA vasculitis in a child: a case report and literature review

Contact Info

Product

Resources

About