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Clinical Analysis of Scrotal Involvement in Childhood Henoch-Schönlein Purpura

Korean Journal of Pediatrics 2004;47(10):1093-1099.
Published online October 15, 2004.
Clinical Analysis of Scrotal Involvement in Childhood Henoch-Schönlein Purpura
Jin-Seok Lee, Tae-Sun Ha
Department of Pediatrics, Chungbuk National University, College of Medicine, Cheongju, Korea
Henoch-Schönlein 자반증 환아의 음낭 침범에 대한 임상적 고찰
이진석, 하태선
충북대학교 의과대학 소아과학교실
Correspondence: 
Tae-Sun Ha, Email: tsha@chungbuk.ac.kr
Abstract
Purpose
: Henoch-Schönlein 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.
Key Words: Henoch-Sch nlein purpura, Scrotal involvement, Acute scrotum


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