Acute scrotum caused by Henoch‐Schönlein purpura

Hara, Yoshinori; Tajiri, Takehiro; Matsuura, K.; Hasegawa, Akio

doi:10.1111/j.1442-2042.2004.00835.x

Cited by 36 publications

(24 citation statements)

References 9 publications

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“…In the literature there are a lot of reports of acute scrotum simultaneously or subsequently to HSP (13,14,15) but according to our knowledge, except the report by Hardoff et al, there is no case of scrotal swelling mimicking testicular torsion preceding HSP.…”

Section: Discussionmentioning

confidence: 72%

A case of scrotal swelling mimicking testicular torsion preceding Henoch-Schönlein vasculitis

Akgün¹

2012

BLL

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Henoch-Schönlein purpura, is one of the most common types of multisystemic vasculitis seen in childhood. The major clinical manifestations are cutaneous purpura, arthritis, abdominal pain, gastrointestinal bleeding, and nephritis. Isolated central nervous system vasculitis, seizures, coma and hemorrhage, Guillan--Barré syndrome, ataxia and central and peripheral neuropathy, ocular involvement, orchitis, epididymitis or testicular torsion are medical or surgical complications. In this study, we report a 7-year-old boy with scrotal swelling mimicking testicular torsion with ultrasonographic and clinical fi ndings that the typical clinical features of Henoch-Schönlein purpura including rashes and arthritis were developed after one week of surgery (Ref. 15) Henoch-Schönlein purpura (HSP) is one of the most common types of multisystemic vasculitis seen in childhood and characterized by non-thrombocytopenic, non-blanching purpura, arthritis, abdominal pain, and renal involvement (1). The epidemiology of HSP is obscure and in the literature there are different values of incidence of this disease. An incidence of 13.5 cases per 100,000 children per year was observed by Stewart M. et al. whereas 0.2-10 cases per 100,000 were reported by Farley et al (2, 3). Although the major clinical manifestations are cutaneous purpura, arthritis, abdominal pain, gastrointestinal bleeding, and nephritis, other manifestations include an isolated central nervous system vasculitis, seizures, coma and hemorrhage, Guillan-Barré syndrome, ataxia and central and peripheral neuropathy, ocular involvement, orchitis, epididymitis or testicular torsion are other medical or surgical conditions that can be seen with HSP (4). The present report details a case of a young Turkish boy with scrotal swelling mimicking testicular torsion with ultrasonographic fi ndings and with the typical clinical features of HSP developed one week after the surgery. Case reportA 7-year-old boy was brought to emergency department with complaints of scrotal swelling and pain lasting 1 day. Except a history of brucellosis 2 years ago, the personal and family histories were unremarkable. Moreover, recent history of infectious disease or trauma was not described. At the time of admission, there were left scrotal edema and testicular pain and he had no rash in any part of the body. The laboratory investigations revealed hemoglobin 13.1 g/dl, white blood cell count 13000/μL and platelet count 462,000/μL. Serum electrolytes, liver enzymes, blood coagulation tests, antinuclear antibody, rheumatoid factor, antistreptolysin O, serum IgA level and urinalysis were within normal levels. On ultrasonographic examination decreased blood fl ow and enlarged testis were seen. Surgical exploration revealed a hematocele, with bloody fl uid accumulation mainly in the tunica vaginalis testis and an edematous, hyperemic testis and epydidymis without torsion of both of them. Edema of testis and epydidymis resolved after surgery. The patient was discharged without any complication on t...

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Section: Discussionmentioning

confidence: 72%

A case of scrotal swelling mimicking testicular torsion preceding Henoch-Schönlein vasculitis

Akgün¹

2012

BLL

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“…HSP affecting the scrotum is well documented, with an incidence of scrotal oedema between 2% and 38% 2. An acute scrotum is a urological emergency, and if testicular torsion is suspected prompt exploration in the theatre is warranted.…”

Section: Discussionmentioning

confidence: 99%

“…However, urological involvement, in particular penile involvement, is exceedingly rare. Most cases are managed conservatively, but in some cases a short-term course of steroids and/or antibiotic therapy may be warranted 2. It is important to note that scrotal involvement is recognised in HSP and should not be mistaken for testicular torsion.…”

Section: Introductionmentioning

confidence: 99%

Unusual presentation of Henöch-Schonlein purpura

Brodie¹,

Natasha

Nitiahpapand

et al. 2018

BMJ Case Reports

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We present a rare case of a 4-year-old boy with newly diagnosed Henöch-Schonlein purpura (HSP) affecting the scrotum and penis. The patient presented to the emergency department with palpable purpura symmetrically distributed over the lower limbs. This was associated with arthritis of the right knee, abdominal pain and scrotal swelling. These symptoms were preceded by an upper respiratory tract infection (URTI). The patient was initially treated with empirical oral antibiotics for epididymitis and was discharged. He subsequently re-presented 12 days later with penile swelling, erythema and tenderness. An ultrasound scan of the penis revealed grossly oedematous subcutaneous tissue with normal penile architecture. His symptoms resolved spontaneously and the patient remains under close follow-up by the paediatric team for further sequelae of HSP.

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“…The patient with HSP usually has cutaneous symptoms such as lower extremity petechiae, as well as renal and rheumatologic symptoms. The scrotum is painful and enlarged [ 23 ]. Ultrasound examination will reveal enlarged epididymis and thickened scrotal skin, as well as reactive hydroceles.…”

Section: Vasculitismentioning

confidence: 96%