Orchitis in Henoch-Schonlein Purpura

Henoch-Schonlein Purpura (HSP) is a most common systemic vasculitis in children characterized by deposition of immune complexes containing the antibody IgA .HSP commonly found in males between the ages of two and eleven. According to EULAR/PRINTO/PRES 12010 the diagnostic criteria HSP include: Palpable purpura-petechiae, not thrombocytopenic/ (mandatory) +≥one of the following.1.Diffuse abdominal pain 2.Histopathology: typical LCV 2 with predominant IgA deposits or proliferative glomerulonephritis with predominant IgA deposits 3.Arthritis or arthralgia 4. Renal involvement (proteinuria˃ 0.3 g/24 h or˃30 mmol/mg of urine albumin to creatinine ratio on a spot morning sample; and/or hematuria, red blood cell casts˃5 red cells per HPF or≥2+ on dipstick or red blood cell casts in the urinary sediment).Uncommon manifestation of HSP includes scrotal disease, pulmonary disease, carditis, and CNS involvement. HSP is diagnosed by its clinical manifestations. Case report: A 5-year-old boy presented to the Emergency with one-day history of rash over both legs. The rashes then gradually spread up till the knees, thighs and to the buttocks. Two days later he complained of painand swelling in his testis/scrotom. There was no history of fever, nausea, vomiting, abdominal pain, hematuria, and scrotal trauma or urinary tract infections. His vital signs were within reference ranges. On physical exam, there were petechial-purpuric rashes diffusely spread over both legs extending up to knees, and buttocks. The abdomen was soft and without organomegaly, tenderness or guarding. Upon joints examination, he had edema and tenderness in his right ankle but no signs of redness, stiffness and decreased range of motion detected. Both testis were erythematous, edematous and tender to palpation but were descended bilaterally and positioned normally. Later on, the boy complained of mild abdominal pain. Blood test revealed normal WBC and HB. CRP was17 mg/.Platelet count was 234× 103/mm3. Urinalysis was normal. Color Doppler Testis sonogeraphy showed no evidence of torsion. Abdominal sonogeraphy was normal.

کلیدواژه ها:

Henoch-Schonlein Purpura ، Epididymo-orchitis ، Acute scrotal swelling