Audiological Profile in Primary Sjögren’s Syndrome in a Tertiary Care Setting and its Clinical Implications

Abstract

This study aims to assess the frequency and the profile of hearing loss among patients with primary Sjögren's syndrome in a tertiary care hospital in India and to look for an association between hearing loss and immunological parameters (anti-SSA antibody, anti-SSB antibody, anticardiolipin antibodies, complements C3 and C4). This prospective observational study was done from January 2011 to October 2011 on consecutive patients diagnosed with primary Sjögren's syndrome in our tertiary care hospital. All patients underwent a puretone audiogram, tympanogram and acoustic reflex testing. The results of the tests were correlated with clinical and immunological findings. The frequency of audiometrically confirmed hearing loss in primary Sjögren's syndrome was estimated to be 78.38 %, though only 17.24 % complained of hearing loss; minimal to mild sensorineural hearing loss were the most common varieties. The commonest finding on tympanometry was 'A' type curve and acoustic reflex was absent in 18.92 % of cases. There was no association between hearing loss and age, sicca symptoms, systemic symptoms or immunological test results in primary Sjögren's syndrome. There was a high prevalence of hearing loss among patients with primary Sjögren's syndrome, but most patients were unaware of this. Hearing assessment and regular monitoring of hearing thresholds is advisable for all patients with primary Sjögren's syndrome.

Evaluation of Medial Olivocochlear Efferent System and Hearing Loss in Patients with Primary Sjögren's Syndrome

“…A significant difference at 125-250-500 Hz between the groups was obtained, differently from some other studies [6]. The statistically significant differences between the pSS and control groups were detected not only at very high frequencies but also in all other frequency ranges (low, middle, high), unlike other studies [7]. The auditory damage resulting from pSS was particularly seen at very high frequencies in the current study, which is supported by some other studies about high-frequency audiometry thresholds of pSS [6,8].…”

“…The present study also investigated middle ear pressures, static compliances, and statistical analyses of these values between the groups. Little research has examined tympanometry results comprehensively [7,8]. Only evidence about the type of tympanogram was presented in these studies.…”

“…Furthermore, autoantibodies are produced in perilymph and endolymph fluids in normal hearing physiology, but in diseases such as pSS they are produced inadequately [5,6]. Some studies showed that the incidence of mild to severe hearing loss in patients with pSS was predicted as 78.38%, though many patients were unaware of their hearing loss [7]. Other studies asserted that patients with pSS have higher hearing thresholds than healthy subjects in the 500-3000 Hz frequency range [8], and recent studies have concentrated on high-frequency hearing loss in pSS [8,9].…”

IL‐1 signaling pathway molecules as key markers in childhood asthma

“…4 Furthermore, elevation of IL-1β has been demonstrated to be implicated in the activation of the IL-1 signaling pathway, which plays an important role in the pathogenesis of various autoimmune diseases. 5 Airway inflammation and immune factors play an important role in the pathogenesis of asthma. It has been reported that IL-1β induction as well as the activation of IL-1 signaling in sputum are implicated in airway neutrophilia and inflammasome activation during asthma.…”

“…Theoretically, antigen stimulation causes an increase in IL‐1α and IL‐1β, the typical innate immune cytokines involved in the initiation and persistence of inflammation, in peripheral blood mononuclear cells (PBMCs) during the exacerbation of asthma 4 . Furthermore, elevation of IL‐1β has been demonstrated to be implicated in the activation of the IL‐1 signaling pathway, which plays an important role in the pathogenesis of various autoimmune diseases 5 …”