Nasal Septal Perforation as The Initial Presentation for Systemic Lupus Erythematosus: A Case Report and Review of The Literature

Section: Case Report
Issue
Vol. 47 No. 2 (2025): Volume 47 Issue 2
Published
Dec 29, 2025
Pages
208-212

Abstract

Background: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease with diverse clinical manifestations. Nasal septal perforation is a rare complication, typically occurring during active disease phases or in established cases. Its presentation as the initial symptom is exceedingly uncommon.


Case Presentation: Authors report a 35-year-old male presenting with recurrent mild nasal bleeding, nasal discomfort, fullness, and intermittent nasal obstruction. Nasal endoscopy revealed a large septal perforation. The patient also exhibited joint pain, stiffness, a mild butterfly rash, photosensitivity, and malaise that preceded nasal symptoms. Laboratory tests showed strongly positive antinuclear antibody (ANA) and IgM anticardiolipin antibodies, with normal urinalysis. Histopathology of nasal mucosa indicated mild lymphomononuclear infiltrate. Based on clinical and laboratory findings, diagnosis of Systemic Lupus Erythematosus (SLE) was established by the rheumatologist.


Conclusion: This case highlights nasal septal perforation as the initial manifestation of SLE, emphasizing the importance of considering autoimmune aetiologies in unexplained nasal perforations. Early recognition can facilitate prompt diagnosis and management of systemic disease.


 

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Authors

Zekeriya Younus

Department of Emergency, Doncaster and Bassetlaw Teaching Hospitals, Doncaster UK

Abdulmohsin Y. Saleem

Early Detection Childhood Disabilities Center, Dohuk, Iraq.

Ali Abdulmuttalib

Department of Surgery, College of Medicine, University of Mosul, Iraq.

Mohammed Saad Azeez

Department of Surgery, College of Medicine, University of Mosul, Iraq.

Identifiers

https://doi.org/10.33899/acmm.v47i2.60197
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1.
Younus Z, Y. Saleem A, Abdulmuttalib A, Saad Azeez M. Nasal Septal Perforation as The Initial Presentation for Systemic Lupus Erythematosus: A Case Report and Review of The Literature. Ann. coll. Med. Mosul [Internet]. 2025 Dec. 29 [cited 2026 Jan. 2];47(2):208-12. Available from: https://mmed.uomosul.edu.iq/index.php/mmed/article/view/60197