Scrotal Involvement: A Rare Clinical Finding in Pediatric Immunoglobulin A Vasculitis

Abstract Background This study sought to analyze patients to identify risk factors for scrotal involvement with childhood immunoglobulin A vasculitis (IgAV), evaluate its association with other systemic involvements, and discuss a tertiary center treatment experience with the literature. Methods The medical records of male patients diagnosed with IgAV between January 2013 and January 2024 and regularly followed for at least 6 months in two pediatric rheumatology centers in Türkiye were reviewed retrospectively. Demographic, clinical, laboratory, radiological, and treatment data were collected from the medical records. Results A total of 339 male pediatric patients with IgA vasculitis were included in this study. The median age of the patients at diagnosis was 8.1 years (range: 2–17). The median follow-up period was one year (6 months to 12 years). Palpable purpura was present in all patients. Gastrointestinal (GI) involvement was observed in 75 (22.1%) patients, joint involvement in 61 (18%), and renal involvement in 50 (14.7%). Scrotal involvement was observed in 36 (10.6%) patients. In the group with scrotal involvement, the rates of GI system involvement, recurrence, and steroid use were statistically significantly higher compared to those without scrotal involvement (p = 0.004, p = 0.011, p < 0.001, respectively). Conclusion This study showed that scrotal involvement was more prevalent in patients with GI system involvement and those with younger age at diagnosis. Furthermore, patients with scrotal involvement required more frequent steroid treatment and experienced more recurrences. Therefore, detailed scrotal evaluation is essential in younger male patients with GI system involvement, and close monitoring for recurrences is crucial.