1.191
IF5
0.947
IF
15
MNiSW
146.95
ICV
Online first
CASE REPORT
 
CC BY-NC 3.0 Polska
 
 

Rare occupational cause of nasal septum perforation: Nickel exposure

Cagri Kulekci 3,  
Umut Kalyoncu 2,  
 
1
Hacettepe University, Ankara, Turkey (Faculty of Medicine, Department of Internal Medicine)
2
Hacettepe University, Ankara, Turkey (Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology)
3
Hacettepe University, Ankara, Turkey (Faculty of Medicine, Department of Otorhinolaryngology)
KEYWORDS:
TOPICS:
ABSTRACT:
Many etiologies are held accountable for nasal septum perforations. Topical nasal drug usage, previous surgeries, trauma, nose picking, squamous cell carcinoma, some rheumatological disorders such as granulomatosis with polyangiitis (Wegener granulomatosis), some infectious diseases such as syphilis and leprosy are among the causes of the perforations. Occupational heavy metal exposures by inhalation rarely may also cause nasal septum perforation. Here, we present a 29-year-old patient without any known diseases, who is a worker at a metallic coating and nickel-plating factory, referred for investigation of his nasal cartilage septum perforation from an otorhinolaryngology clinic. The patient questioning, physical examination and laboratory assessment about rheumatic and infectious diseases were negative. There was a metallic smell in the breath during the physical examination. The analysis showed serum nickel level at 31 μg/l and urine nickel at 18 μg/l (84.11 μg/g creatinine). Other possible serum and urine heavy metal levels were within normal ranges. Nickel exposure is usually together with other heavy metals (chromium or cadmium), it is rarely alone. Nickel ingested by inhalation usually leads to respiratory problems such as reduced olfactory acuity, ulcers, septum perforation or tumors of the nasal sinuses. This case demonstrates the importance of occupational anamnesis and awareness of diagnosis. Int J Occup Med Environ Health 2017;30(6)
CORRESPONDING AUTHOR:
Ertugrul Cagri Bolek   
Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Gevher Nesibe Street, 06100 Sihhiye/Ankara, Turkey
eISSN:1896-494X
ISSN:1232-1087