Prevalence of Hearing Impairment Among Systemic Lupus Erythematosus Patients
Article Sidebar
Main Article Content
Abstract
Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease with varied manifestations, including potential auditory complications. Previous studies have indicated varying prevalence rates of hearing impairment among SLE patients, necessitating further research to understand the extent and nature of these auditory issues.
Objective: The primary aim of this study was to assess the prevalence and characteristics of hearing impairment in SLE patients, with a focus on identifying the types and degrees of hearing loss and associated symptoms like tinnitus and vertigo.
Methods: This observational, cross-sectional study involved 38 SLE patients from Sir Ganga Ram Hospital, Lahore, and DHQ Hospital, Bhimber, Kashmir. Participants underwent pure tone audiometry (PTA) to assess hearing impairment. Data were analyzed using SPSS version 24.0, with a focus on qualitative variables like gender, education, and socio-economic status. Patients with SLE-associated co-morbid factors affecting hearing were excluded.
Results: The study found a 29% prevalence of hearing impairment among SLE patients, with sensorineural hearing loss being the most common type (21.1%). Conductive hearing loss and mixed hearing loss were observed in 2.6% and 5.3% of patients, respectively. The majority of hearing impairments were of mild to moderate degree. Additionally, 23.7% of patients reported tinnitus, and 18.45% experienced vertigo.
Conclusion: The study concludes that hearing impairment, particularly sensorineural hearing loss of a mild to moderate degree, is a significant concern in SLE patients. The findings highlight the need for routine audiological assessments, including PTA and High Frequency Audiometry (HFA), in the management of SLE patients to facilitate early detection and treatment of hearing loss.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Agrawal G, Varghese B, Balde M, Wazir S. Neonatal lupus erythematosus presenting with rash, thrombocytopenia compounded by cytomegalovirus colonisation: a diagnostic dilemma. BMJ case reports. 2020;13(6).
Alkhunaizi E, Unger S, Shannon P, Nishimura G, Blaser S, Chitayat D. Maternal SLE and brachytelephalangic chondrodysplasia punctata in a patient with unrelated de novo RAF1 and SIX2 variants. American journal of medical genetics Part A. 2020;182(7):1807-11.
Borchers AT, Naguwa SM, Shoenfeld Y, Gershwin ME. The geoepidemiology of systemic lupus erythematosus. Autoimmun Rev. 2010;9(5):A277-A87.
Saeed M, Pasha A, Rizvi SHA, Munawar M, Elias ZA, Shafi MI, et al. Remission and clinical patterns of systemic lupus erythematosus (SLE) in Pakistan: a retrospective cohort study. medRxiv. 2022:2022.11. 28.22282863.
Barber MR, Drenkard C, Falasinnu T, Hoi A, Mak A, Kow NY, et al. Global epidemiology of systemic lupus erythematosus. Nature Reviews Rheumatology. 2021;17(9):515-32.
Hennermann JB, Raebel EM, Donà F, Jacquemont ML, Cefalo G, Ballabeni A, et al. Mortality in patients with alpha-mannosidosis: a review of patients' data and the literature. Orphanet journal of rare diseases. 2022;17(1):287.
Kaneko S, Shimizu M, Shimbo A, Irabu H, Yamazaki S, Kanamori T, et al. A girl with hearing loss, dizziness, hypertension, and pyelonephritis with ureteral edema: Answers. Pediatric nephrology (Berlin, Germany). 2022;37(12):3059-61.
Li X, Cao Z, Chen F, Yang D, Zhao F. Sensorineural Hearing Loss in Autoimmune Diseases: A Systematic Review and Meta-analysis. The journal of international advanced otology. 2023;19(4):277-82.
Liu J, Li M, Liang JY, Xu XF, Zeng WG, Wang YJ, et al. Autoimmune diseases in HIV-negative cryptococcal meningitis. Future microbiology. 2021;16:1251-9.
Martz CD, Allen AM, Fuller-Rowell TE, Spears EC, Lim SS, Drenkard C, et al. Vicarious Racism Stress and Disease Activity: the Black Women's Experiences Living with Lupus (BeWELL) Study. Journal of racial and ethnic health disparities. 2019;6(5):1044-51.
Okawa Y, Ihara K. Sensorineural Hearing Loss in Sjögren's Syndrome. International journal of molecular sciences. 2022;23(19).
Xie S, Ning H, She Y, Jing Q, Jiang Q, Zhang Y, et al. Effect of systemic lupus erythematosus and rheumatoid arthritis on sudden sensorineural hearing loss. Laryngoscope. 2020;130(10):2475-80.
Yuen E, Fried J, Nguyen SA, Rizk HG, Ward C, Meyer TA. Hearing loss in patients with systemic lupus erythematosus: A systematic review and meta-analysis. Lupus. 2021;30(6):937-45.
Cunningham LL, Tucci DL. Hearing loss in adults. New England Journal of Medicine. 2017;377(25):2465-73.
Gabr TA, Kotait MA, Abdel Noor RA. Audiovestibular findings in autoimmune diseases. The Egyptian Journal of Otolaryngology. 2019;35:71-8.
Triplett JD, Buzzard KA, Lubomski M, Riminton DS, Barnett MH, Welgampola MS, et al. Immune-mediated conditions affecting the brain, eye and ear (BEE syndromes). Journal of neurology, neurosurgery, and psychiatry. 2019;90(8):882-94.
Tsirves GK, Voulgari PV, Pelechas E, Asimakopoulos AD, Drosos AA. Cochlear involvement in patients with systemic autoimmune rheumatic diseases: a clinical and laboratory comparative study. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2019;276(9):2419-26.
Chen R, Schwander M, Barbe MF, Chan MM. Ossicular bone damage and hearing loss in rheumatoid arthritis: a correlated functional and high resolution morphometric study in collagen-induced arthritic mice. PLoS One. 2016;11(9):e0164078.
Fernandes MRdN, Soares DBR, Thien CI, Carneiro S. Hydroxychloroquine ototoxicity in a patient with systemic lupus erythematosus. An Bras Dermatol. 2018;93:469-70.
Paraschou V, Chaitidis N, Papadopoulou Z, Theocharis P, Siolos P, Festas C. Association of systemic lupus erythematosus with hearing loss: a systemic review and meta-analysis. Rheumatology international. 2021;41(4):681-9.
Polanski JF, Tanaka EA, Barros H, Chuchene AG, Miguel PTG, Skare TL. Chloroquine, Hydroxychloroquine and Hearing Loss: A Study in Systemic Lupus Erythematosus Patients. Laryngoscope. 2021;131(3):E957-e60.
da Mata Rezende MdS, Iório MCM. A study of auditory evoked potentials in systemic lúpus erythematosus patients. Braz J Otorhinolaryngol. 2008;74(3):429-39.
Rahne T, Plontke S, Keyßer G. Vasculitis and the ear: a literature review. Current opinion in rheumatology. 2020;32(1):47-52.
Riera JL, Del RMM, Musuruana JL, Cavallasca JA. Sudden Sensorineural Hearing Loss in Systemic Lupus Erythematosus and Antiphospholipid Syndrome: A Clinical Review. Current rheumatology reviews. 2020;16(2):84-91.
Tan CL, Yahaya MH, Ahmad NS, Lim CH. Macrophage activation syndrome as an initial presentation of systemic lupus erythematosus with sensorineural hearing loss in a young male patient. BMJ case reports. 2020;13(3).
Sample size calculator 2023 [updated 24.5.2023; cited 2023 24 may]. Available from: https://journals.sagepub.com/doi/pdf/10.1177/0961203321997919.
Fanouriakis A, Tziolos N, Bertsias G, Boumpas DT. Update οn the diagnosis and management of systemic lupus erythematosus. Annals of the rheumatic diseases. 2021;80(1):14-25.
Vittorini P, Chamoso P, De la Prieta F. A device and an app for the diagnosis and self-management of tinnitus. Journal of Integrative Bioinformatics. 2022;19(3):20220004.
Katyayan A, Katyayan A, Rajput A, Chandra M, Verma V, Mishra A. Validation of app-based hearing assessment (H3 hearing test) through smart phone: preliminary trends. Hearing, Balance and Communication. 2022;20(4):279-84.
Jalali MM, Nasimidoust Azgomi M. Metabolic syndrome components and sudden sensorineural hearing loss: a case–control study. European Archives of Oto-Rhino-Laryngology. 2020;277:1023-9.
Tharwat S, Elshawaf W, Nassar MK. Audiologic evaluation in systemic lupus erythematosus patients and impact of hydroxychloroquine therapy. The Egyptian Rheumatologist. 2022;44(2):171-4.
Chen H, Wang F, Yang Y, Hua B, Wang H, Chen J, et al. Characteristics of Hearing Loss in Patients with Systemic Lupus Erythematosus. Journal of Clinical Medicine. 2022;11(24):7527.
Alzokm SM, Ghanem SS. Hearing disorders in lupus patients: correlation with duration and severity of the disease. Egyptian Rheumatology and Rehabilitation. 2022;49(1):23.
Mokbel AN, Hassan SZ, Zohdi MI, ElShennawy AM. Auditory disorders in patients with systemic lupus erythematosus: Relation to clinical parameters. The Egyptian Rheumatologist. 2014;36(3):117-24.