Cochlear Histopathologic Findings in Patients With Systemic Lupus Erythematosus

Kariya, Shin; Kaya, Serdar; Hızlı, Ömer; Hizli, Pelin; Nishizaki, Kazunori; Paparella, Michael M.; Cüreoğlu, Sebahattin

doi:10.1097/mao.0000000000001017

Cited by 13 publications

(9 citation statements)

References 26 publications

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“…Kariya et al . examined 15 temporal bone samples from 8 systemic lupus erythematosus patients, along with 17 samples from 10 age-matched healthy control patients 24 . They found a positive correlation between the loss of cochlear hair cells and the duration of systemic lupus erythematosus, and concluded that it represented the histopathological basis for the cochlear dysfunction, including SNHL, experienced by systemic lupus erythematosus patients.…”

Section: Discussionmentioning

confidence: 99%

Intratympanic gadolinium magnetic resonance imaging supports the role of endolymphatic hydrops in the pathogenesis of immune-mediated inner-ear disease

et al. 2018

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This study confirms the presence of endolymphatic hydrops in immune-mediated inner-ear disease patients. The virtual absence of hydrops in patients with secondary immune-mediated inner-ear disease is remarkable, although firm conclusions cannot be drawn; this should be explored in a multicentre study with a larger sample of patients. A different immune reaction without development of endolymphatic hydrops should not be ruled out in secondary immune-mediated inner-ear disease patients.

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Section: Discussionmentioning

confidence: 99%

Intratympanic gadolinium magnetic resonance imaging supports the role of endolymphatic hydrops in the pathogenesis of immune-mediated inner-ear disease

et al. 2018

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“… 30 Vasculitis appears to be the major factor involved in cochlear and vestibular damage. 2 , 12 , 13 , 25 , 36 , 37 …”

Section: Pathophysiology Of Inner Ear Involvement In Slementioning

confidence: 99%

Systemic Lupus Erythematosus and hearing disorders: Literature review and meta-analysis of clinical and temporal bone findings

Stadio

Ralli

2017

J Int Med Res

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ObjectiveThis literature review and meta-analysis was performed to evaluate the correlations among hearing and vestibular clinical symptoms, temporal bone findings, and pathological mechanisms in patients with systemic lupus erythematosus (SLE).Study designRelevant papers in the literature were retrospectively reviewed. Clinical hearing aspects in patients with SLE and relevant temporal bone studies in the same field were analyzed.MethodsPubMed and Google Scholar searches were performed using the following keywords: “auto-immune disease,” “systemic lupus erythematosus (SLE),” “hearing loss,” “temporal bone study,” “vertigo,” “dizziness,” “tinnitus,” “ear symptoms,” “treatment,” “diagnosis,” “symptoms,” “etiopathogenesis,” “Wegener granulomatosis,” “Sjogren,” “polyarteritis nodosa,” “Cogan syndrome,” and “granulomatosis.” Also included were reviews in which the following terms were present: “SLE,” “temporal bone,” and “hearing symptoms.”Review and conclusionThis literature review and meta-analysis focused on the pathological mechanisms through which SLE can damage inner ear structures and determinate hearing and vestibular symptoms. The main mechanisms involved in inner ear damage include the autoimmune response, deposition of immune complexes in the vessels and, to a lesser extent, cytotoxic damage.

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“…33 Atrophy of the stria vascularis and loss of spiral ganglion cells are observed in systemic lupus erythematous. [34][35][36] These inflammatory processes result in fibrosis and osteoneogenesis [37][38][39] and retrograde neuronal degeneration. 26…”

Section: Histopathologymentioning

confidence: 99%

“…Basement membrane Immunoglobulin G deposition and loss of spiral ganglion neurons have been observed in Sjögren's . Atrophy of the stria vascularis and loss of spiral ganglion cells are observed in systemic lupus erythematous . These inflammatory processes result in fibrosis and osteoneogenesis and retrograde neuronal degeneration …”

Section: Histopathologymentioning

confidence: 99%

Emerging options in immune‐mediated hearing loss

Sakano

Harris

2018

Laryngoscope Investig Oto

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Objective AIED (autoimmune inner ear disease) is an autoimmune process that leads to the dysfunction of the inner ear, resulting in fluctuating, audiovestibular symptoms. Although the pathogenesis is likely heterogeneous, immune processes within the inner ear ultimately lead to histopathologic changes and sensorineural hearing loss. This review will discuss the latest evidence on treatment options. Methods A literature search on articles pertaining to the treatment of autoimmune inner ear disease was performed on PubMed. Results Corticosteroid treatment continues to remain as first line therapy for AIED but long‐term responsiveness is poor. Cytotoxic chemotherapies can be effective alternatives for steroid nonresponsive patients, but significant side effects may limit their use. Intratympanic steroid injections are beneficial and although there is not enough evidence currently to supplant oral steroid trial they may be a useful adjunct if steroid toxicity is an issue. The efficacy of biologic agents has been variable. Compared to placebo, etanercept does not improve the hearing improvement already attained by steroids alone. However, open pilot studies of other biologic agents show hearing improvements, improvements in tinnitus/aural fullness/vertigo, ability to wean steroid dependency, or benefits in steroid‐resistant AIED. Conclusion There is currently not enough evidence that alternative treatments supersede the use of initial steroid treatment. Biologic agents and intratympanic steroid injections are relatively well tolerated and should be considered as adjunctive therapy. More studies on the efficacy of various biologics and more studies on the treatment of steroid resistant disease especially after initial benefit are still needed. For those who eventually lose their hearing, cochlear implantation remains as a viable option. Level of Evidence expert opinion.

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Cochlear Histopathologic Findings in Patients With Systemic Lupus Erythematosus

Cited by 13 publications

References 26 publications

Intratympanic gadolinium magnetic resonance imaging supports the role of endolymphatic hydrops in the pathogenesis of immune-mediated inner-ear disease

Intratympanic gadolinium magnetic resonance imaging supports the role of endolymphatic hydrops in the pathogenesis of immune-mediated inner-ear disease

Systemic Lupus Erythematosus and hearing disorders: Literature review and meta-analysis of clinical and temporal bone findings

Emerging options in immune‐mediated hearing loss

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