Nasal septal perforation in adult Still's disease

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine Pub Date : 2025-07-01 DOI:10.1016/j.jbspin.2025.105942

Esra Erpek , Eren Erdem , Ediboğlu Elif , Solmaz Dilek , Akar Servet

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Abstract

Background

Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder characterized by fever, rash, arthritis, and pharyngitis. Ear, nose, and throat (ENT) complications beyond pharyngitis are uncommon.

Case presentation

A 31-year-old female presented with fever, sore throat, maculopapular rash, and arthritis. Laboratory findings revealed elevated inflammatory markers, hyperferritinemia, and leukocytosis. After extensive exclusion of infectious and autoimmune causes, AOSD was diagnosed, and treatment with corticosteroids and methotrexate was initiated. Clinical symptoms improved within a week. However, one month later, the patient developed nasal bleeding and crusting. ENT examination revealed anterior nasal septal perforation. Known causes of septal perforation, including infection, trauma, intranasal drug use, and vasoconstrictor sprays, were excluded.

Conclusion

This case highlights nasal septal perforation as a rare and possibly underrecognized complication of AOSD. Clinicians should consider ENT evaluation during both active disease and follow-up periods.

查看原文本刊更多论文

成人Still病的鼻中隔穿孔。

背景：成人发病的斯蒂尔氏病（AOSD）是一种罕见的全身性炎症性疾病，以发热、皮疹、关节炎和咽炎为特征。耳鼻喉（ENT）并发症除了咽炎是罕见的。病例介绍：一名31岁女性，表现为发烧、喉咙痛、斑疹丘疹和关节炎。实验室结果显示炎症标志物升高，高铁蛋白血症和白细胞增多。在广泛排除感染和自身免疫性原因后，AOSD被诊断出来，并开始使用皮质类固醇和甲氨蝶呤治疗。临床症状在一周内得到改善。然而，一个月后，患者出现鼻出血和结痂。耳鼻喉检查发现前鼻中隔穿孔。已知的室间隔穿孔原因，包括感染、外伤、鼻内用药和血管收缩剂喷雾剂，均被排除在外。结论：本病例强调鼻中隔穿孔是一种罕见且可能被低估的AOSD并发症。临床医生应考虑在活动性疾病和随访期间进行耳鼻喉科评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Joint Bone Spine 医学-风湿病学

CiteScore

4.50

自引率

11.90%

发文量

184

审稿时长

25 days

期刊介绍： Bimonthly e-only international journal, Joint Bone Spine publishes in English original research articles and all the latest advances that deal with disorders affecting the joints, bones, and spine and, more generally, the entire field of rheumatology. All submitted manuscripts to the journal are subjected to rigorous peer review by international experts: under no circumstances does the journal guarantee publication before the editorial board makes its final decision. (Surgical techniques and work focusing specifically on orthopedic surgery are not within the scope of the journal.)Joint Bone Spine is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.