Unusual presentation of immunoglobulin A vasculitis with acute scrotal swelling and epididymo orchitis in a 5-year-old boy

Sahithi Putcha; Maheswari Katakamsetty

doi:10.18203/2349-3291.ijcp20250773

Authors

Sahithi Putcha Department of Pediatrics, Children’s Hospital of Michigan, Detroit, USA
Maheswari Katakamsetty Department of Radiology, Maharaja Institute of Medical Sciences, Vijayanagaram, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20250773

Keywords:

IgA vasculitis, Henoch-Schönlein purpura, Epididymitis, Orchitis, Purpura

Abstract

Immunoglobulin A (IgA) vasculitis, formerly known as Henoch-Schönlein purpura (HSP), is a small vessel vasculitis primarily affecting children. It commonly presents with palpable purpura, arthralgia, abdominal pain, and renal involvement. However, atypical presentations can occur, posing diagnostic challenges. Here, we present a case of IgA vasculitis in a 5-year-old boy with a unique manifestation of epididymitis as the primary presenting symptom. Scrotal ultrasound demonstrated Epididymo-orchitis with funiculitis. Skin examination revealed scattered palpable purpura over the lower extremities. Thus, a clinical diagnosis of IgA Vasculitis is made. The patient recovered with corticosteroids and supportive care.

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References

Modi S, Mohan M, Jennings A. Acute Scrotal Swelling in Henoch-Schonlein Purpura: Case Report and Review of the Literature. Urol Case Rep. 2016;6:9-11. DOI: https://doi.org/10.1016/j.eucr.2016.01.004

Brodie A, Natasha G, Nitiahpapand R, Chowoo L. Unusual presentation of Henöch-Schonlein purpura. BMJ Case Rep. 2018;bcr2017220129. DOI: https://doi.org/10.1136/bcr-2017-220129

Ma Y, Zhang S, Chen J, Kong H, Diao J. Henoch-Schönlein Purpura with Scrotal Involvement: A Case Report and Literature Review. J Pediatr Hematol/Oncol. 2021;43(6):211-5. DOI: https://doi.org/10.1097/MPH.0000000000002161

Montorfani-Janett VML, Montorfani GE, Lavagno C, Gualco G, Bianchetti MG, Milani GP, et al. External Male Genitalia in Henoch–Schönlein Syndrome: A Systematic Review. Children. 2022;9(8):1154. DOI: https://doi.org/10.3390/children9081154

Turkish VJ, Traisman HS, Belman AB, Given GZ, Marr TJ. Scrotal swelling in the Scho¨nlein-Henoch syndrome. J Urol 1976;115(3):317e9. DOI: https://doi.org/10.1016/S0022-5347(17)59185-5

Verim L, Cebeci F, Erdem MR, Somay A. Henoch-Schönlein purpura without systemic involvement beginning with acute scrotum and mimicking torsion of testis. Arch Ital Urol Androl. 2013;85(1):50-2. DOI: https://doi.org/10.4081/aiua.2013.1.50

Riazat MI, Rai B, Sharif F. P92 Epididymitis in henoch-schonlein purpura, an unusual presentation of a common vasculitic condition in children. Arch Dis Childhood. 2019;104:A193. DOI: https://doi.org/10.1136/archdischild-2019-epa.447

Dalpiaz A, Schwamb R, Miao Y, Gonka J, Walzter W, Khan SA. Urological manifestations of Henoch-Schonlein purpura: a review. Curr Urol. 2015;8(2):66-73. DOI: https://doi.org/10.1159/000365692

Ha TS, Lee JS. Scrotal involvement in childhood Henoch-Scho€nlein purpura. Acta Paediatr. 2007;96(4):552-5. DOI: https://doi.org/10.1111/j.1651-2227.2006.00173.x

Shaher HM, Alzahrani AS, Alshaalan HM. Unusual Testicular Ultrasound Findings in a Child with Henoch-Schönlein Purpura. J Med Ultrasound. 2013;21(4):217-20. DOI: https://doi.org/10.1016/j.jmu.2013.10.004