Abstract: Nasal Septal Perforation: A Novel Clinical Manifestation of Systemic Juvenile Idiopathic Arthritis/Adult Onset Still's Disease

Nasal Septal Perforation: A Novel Clinical Manifestation of Systemic Juvenile Idiopathic Arthritis/Adult Onset Still's Disease

TADEJ AVCIN, EARL D. SILVERMAN, VITO FORTE, and RAYFEL SCHNEIDER

ABSTRACT.

Nasal septal perforation has been well recognized in patients with various rheumatic diseases. To our knowledge, this condition has not been reported in children with systemic juvenile idiopathic arthritis (SJIA) or patients with adult onset Still's disease (AOSD). We describe 3 patients with persistent SJIA/AOSD who developed nasal septal perforation during the course of their disease. As illustrated by these cases, nasal septal perforation may develop as a rare complication of SJIA/AOSD and can be considered as part of the clinical spectrum of the disease. In one case the nasal septal perforation was associated with vasculitis. (J Rheumatol 2005;32:2429-31)

Key Indexing Terms:

SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS
ADULT ONSET STILL'S DISEASE
NASAL SEPTAL PERFORATION

From the Division of Rheumatology and Department of Otolaryngology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

T. Avcin, MD, PhD, Clinical Fellow, Division of Rheumatology; E.D. Silverman, MD, FRCPC, Professor of Pediatrics and Immunology, Division of Rheumatology; V. Forte, MD, FRCSC, Associate Professor of Otolaryngology, Department of Otolaryngology; R. Schneider, MBBCh, FRCPC, Associate Professor of Pediatrics, Head, Division of Rheumatology.

Address reprint requests to Dr. R. Schneider, Division of Rheumatology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8. E-mail: rayfel.schneider@sickkids.ca

Accepted for publication July 21, 2005.