Clinical Analysis of Scrotal Involvement in Childhood Henoch-Schonlein Purpura

Lee, Jin Seok; Ha, Tae Sun

Abstract

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.