Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 10;184(5):289.
doi: 10.1007/s00431-025-06120-w.

Characteristics of scrotal involvement in IgA vasculitis: Relationship with disease activity and inflammatory markers

Seyma Ertem  1 , Zahide Ekici Tekin  2 , Merve Cansu Polat  2 , Didem Öztürk  2 , Emine Özçelik  2 , Mehveş Işıklar Ekici  2 , Yasemin Uğur Es  2 , Sultan Nilay Yoğun  2 , Şeyma Erdem Torun  2 , Cüneyt Karagöl  2 , Banu Çelikel Acar  2
Affiliations

Characteristics of scrotal involvement in IgA vasculitis: Relationship with disease activity and inflammatory markers

Seyma Ertem et al. Eur J Pediatr. .

Abstract

Immunoglobulin A (IgA) vasculitis is a common systemic vasculitis in children, involving the skin, joint, gastrointestinal tract and kidneys. Scrotal involvement is a less common manifestation in the course of IgA vasculitis, which alters disease management. The purpose of this study was to present the characteristics of patients with IgA vasculitis with scrotal involvement and to compare patients with and without scrotal involvement. We also aimed to investigate the relationship between scrotal involvement and disease activity and inflammatory markers. This medical record review study was conducted in 234 male patients under the age of 18 years who were diagnosed with IgA vasculitis and followed for at least 6 months in the Pediatric Rheumatology Clinic. Demographic characteristics, clinical findings, laboratory findings, and pediatric vasculitis activity score (PVAS) of IgA vasculitis patients were recorded. CRP to albumin ratio (CAR), platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) were calculated using the patients' complete blood count parameters and C reactive protein (CRP) levels. Two hundred thirty four male patients with IgA vasculitis were included in the study. Scrotum involvement was detected in 34 (14.5%) of patients. The mean age at diagnosis of 34 patients with scrotal involvement was 7.37 (4.41-8.43) years. Of the 34 patients, 15 had scrotal pain, swelling and rash, 12 had scrotal pain and swelling, and 2 had only scrotal swelling. Two (5.9%) patients had penile involvement with scrotal involvement. Patients were divided into two groups as those with scrotal involvement (n = 34, 10.2%) and those without (n = 200, 89.8%). Local edema, widespread skin involvement, hematuria, penile involvement, PVAS and CAR were significantly higher in IgA patients with scrotal involvement than in those without (p < 0.001, p < 0.001, p = 0.019, p = 0.001, p < 0.001, and p = 0.004, respectively).

Conclusion: Widespread purpura, local edema, penile involvement and hematuria are more common in patients with scrotal involvement than those without. PVAS and some systemic inflammatory markers such as CAR may be helpful in predicting scrotal involvement.

What is known: • IgA vasculitis is the most common type of vasculitis in childhood and scrotal involvement is very rare during the course of the disease. • PVAS is a scoring system used to measure the severity of childhood vasculitis.

What is new: • PVAS might be promising surrogate tool for predicting scrotal involvement in patients with IgA vasculitis.

Keywords: IgA vasculitis; Inflammation; Pediatric vasculitis activity score; Scrotal involvement.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethical approval: The study was conducted in accordance with the principles of the Declaration of Helsinki. The study was approved by the ethical committee of Ankara Bilkent City Hospital (audit ref. No: TABED- 1–362). Conflict of interest: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Receiver operating characteristic curve analyses conducted to determine the cut-off values for the sensitivity and specificity of CAR for predicting scrotal involvement
Fig. 2
Fig. 2
Receiver operating characteristic curve analyses conducted to determine the cut-off values for the sensitivity and specificity of PVAS for predicting scrotal involvement
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F et al (2013) 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 65(1):1–11. 10.1002/art.37715 - PubMed
    1. Ozen S, Bakkaloglu A, Dusunsel R, Soylemezoglu O, Ozaltin F, Poyrazoglu H et al (2007) Childhood vasculitides in Turkey: a nationwide survey. Clin Rheumatol 26(2):196–200. 10.1007/s10067-006-0266-6 - PubMed
    1. Karadag SG, Tanatar A, Sonmez HE, Cakmak F, Kiyak A, Yavuz S et al (2019) The clinical spectrum of Henoch-Schonlein purpura in children: a single-center study. Clin Rheumatol 38(6):1707–1714. 10.1007/s10067-019-04460-1 - PubMed
    1. Ozen S, Sag E (2020) Childhood vasculitis. Rheumatology 59(Suppl 3):iii95–iii100. 10.1093/rheumatology/kez599 - PubMed
    1. Buscatti IM, Abrao HM, Kozu K, Marques VLS, Gomes RC, Sallum AME et al (2018) Characterization of scrotal involvement in children and adolescents with IgA vasculitis. Advances in rheumatology 58(1):38. 10.1186/s42358-018-0039-3 - PubMed