Ha Tae-Sun, Lee Jin-Seok
Department of Pediatrics, College of Medicine, Chungbuk National University Hospital, Cheongju, Korea.
Acta Paediatr. 2007 Apr;96(4):552-5. doi: 10.1111/j.1651-2227.2006.00173.x. Epub 2007 Feb 14.
Henoch-Schönlein purpura (HSP) is a common childhood systemic vasculitis involving the skin, gastrointestinal tract, joint, kidneys and even scrotum.
We retrospectively reviewed the clinical and laboratory data of 120 male patients with HSP and also evaluated the risk factors for scrotal involvement and the relation between scrotal involvement and other clinical features. Twenty-six out of 120 boys (21.7%) diagnosed with HSP had scrotal involvement.
Scrotal symptoms manifested as swelling in 88.5% and pain (or tenderness) in 69.2% of HSP patients with scrotal involvement. Neurologic symptoms, mainly headache and localized edema among various manifestations and high serum C3 level of laboratory profiles were more frequently observed in scrotal-involved group than in those of non-involved group. However, there was no difference in the outcomes of scrotal symptoms according to therapeutic modalities and the occurrence of scrotal involvement had no correlation with renal involvement from acute to chronic phase.
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, the accurate early diagnosis of HSP is mandatory by the early notification of purpura and imaging evaluations in order to avoid unnecessary procedures.
过敏性紫癜（HSP）是一种常见的儿童系统性血管炎，可累及皮肤、胃肠道、关节、肾脏甚至阴囊。
我们回顾性分析了120例男性HSP患者的临床和实验室数据，评估了阴囊受累的危险因素以及阴囊受累与其他临床特征之间的关系。120例诊断为HSP的男孩中有26例（21.7%）出现阴囊受累。
在阴囊受累的HSP患者中，88.5%的患者阴囊症状表现为肿胀，69.2%的患者表现为疼痛（或压痛）。与未受累组相比，阴囊受累组在各种表现中更常出现神经系统症状，主要是头痛和局部水肿，实验室检查中血清C3水平较高。然而，根据治疗方式，阴囊症状的结局并无差异，并且从急性期到慢性期，阴囊受累的发生与肾脏受累无关。
我们发现，神经系统症状、局部水肿和高血清C3水平与男性HSP患者的阴囊受累显著相关。由于男性HSP患者出现阴囊受累并不罕见，因此必须通过紫癜的早期告知和影像学评估进行HSP 的准确早期诊断，以避免不必要的检查。
