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Anaphylactoid purpura/Henoch-Schonlein Purpura
Palpable purpura on extensor surfaces of extremities + edema, arthralgia/arthritis, colicky abdominal pain with GI bleeding, acute scrotal pain, and/or renal dysfunction.
"Sack of worms" feeling in one testicle. Generally not painful but may be tender with exercise. Occurs in 15% of males over 10 years old. Usually occurs on the left. May compromise fertility in which case surgery is indicated. Otherwise education and reassurance suffice.
Accumulation of fluid in the tunica vaginalis around testicle. Transilluminates well. Small ones usually spontaneously resolve within a year. Larger ones may require surgery. Seen in 2% of male neonates.
Most common hereditary nephritis. Typical presentation is microscopic hematuria, especially after URI. 30 - 75% of cases are associated with progressive hearing loss. End stage renal failure is common by 20s - 30s. Usually x-linked. Ocular abnormalities may be seen, as well as rare leiomyomatosis of esophagus or respiratory tract.
8 year old with intermittent burning upon urination and trace blood on dipstick. Characterized by persistent microscopic hematuria and intermittent macroscopic hematuria. Accompanied by abdominal pain and dysuria without stone formation.
6 year old boy with puffy eyes in the morning and scrotal swelling at night. Labs show elevated triglycerides and cholesterol. Other findings will include: low albumin, decrease in plasma volume, proteinuria. Treatment may include monitoring and salt and water restriction.
Often seen post strep infection. Common presentation is fatigue, cola-colored urine, and elevated blood pressure. Fluid intake should be restricted when oliguria is present.
Juxtaglomerular hyperplasia. Autosomal recessive. Causes hypokalemia, hypercalciuria, alkalosis, hyperaldosteronism, and hyerreninemia. Presents between 6-12 months with FTT, constipation, vomiting, polyuria, polydipsia. Treatment is fluid replacement, potassium correction, and nutrition.
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