Risk of Sudden Sensorineural Hearing Loss in Patients with Systemic Lupus Erythematosus: A Population-Based Cohort Study

Lin, Charlene; Lin, Shih Wei; Weng, Shih‐Feng; Lin, Yong-Song

doi:10.1159/000345512

Cited by 42 publications

(31 citation statements)

References 35 publications

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“…In a retrospective cohort population study in patients with SLE in the population of Taiwan, Lin et al 5 reinforce the relationship between SLE and sudden SNHL by showing that patients affected by this immune-mediated disease have an incidence rate of sudden SNHL up to 4.27 times higher than the general population. …”

Section: Discussionmentioning

confidence: 94%

Sudden Sensorioneural Hearing Loss and Autoimmune Systemic Diseases

Rossini

Penido

Munhoz

et al. 2016

Int Arch Otorhinolaryngol

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Introduction Several authors have demonstrated the relationship between sudden sensorineural hearing loss (SNHL) and systemic autoimmune diseases (SAD). Immune-mediated SNHL can rarely present as unilateral sudden SNHL and manifests itself in the contralateral ear only after years. It presents clinical relevance for being one of the few SNHL that may be reversible given that early and appropriate treatment is applied. Objective The objective of this study is to describe the clinical presentations and audiological findings from patients with idiopathic sudden SNHL and SAD associated with a probable diagnosis of immune-mediated SNHL. Furthermore, we strive to estimate the prevalence of SAD in patients with sudden SNHL. Methods This is an observational retrospective cohort. We have selected and studied patients with SAD. Revision of available literature on scientific repositories. Results We evaluated 339 patients with sudden SNHL. Among them, 13 (3.83%) patients suffered from SAD. Three patients had bilateral involvement, a total of 16 ears. We evaluate and describe various clinical, epidemiological, and audiological aspects of this sample. Conclusion In our sample of patients with sudden SNHL, the prevalence of SAD was found relevant. The majority had tinnitus and dizziness concomitant hearing loss, unilateral involvement and had experienced profound hearing loss at the time of the installation. In spite of instituted treatment, most cases showed no improvement in audiometric thresholds. Apparently, patients with sudden SNHL and SAD have a more severe initial impairment, higher percentage of bilateral, lower response to treatment, and worse prognosis than patients with sudden SNHL of unknown etiology.

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Section: Discussionmentioning

confidence: 94%

Sudden Sensorioneural Hearing Loss and Autoimmune Systemic Diseases

Rossini

Penido

Munhoz

et al. 2016

Int Arch Otorhinolaryngol

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“…Systemic lupus erythematosus (SLE) is an autoimmune disease with multiorgan involvement and an incidence higher in women (82%–96%) than in men (4%–18%) [29]. …”

Section: Inner Ear Involvement In Autoimmune Diseasesmentioning

confidence: 99%

Audiovestibular Symptoms in Systemic Autoimmune Diseases

Ralli

D’Aguanno

Stadio

et al. 2018

Journal of Immunology Research

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Immune-mediated inner ear disease can be primary, when the autoimmune response is against the inner ear, or secondary. The latter is characterized by the involvement of the ear in the presence of systemic autoimmune conditions. Sensorineural hearing loss is the most common audiovestibular symptom associated with systemic autoimmune diseases, although conductive hearing impairment may also be present. Hearing loss may present in a sudden, slowly, rapidly progressive or fluctuating form, and is mostly bilateral and asymmetric. Hearing loss shows a good response to corticosteroid therapy that may lead to near-complete hearing restoration. Vestibular symptoms, tinnitus, and aural fullness can be found in patients with systemic autoimmune diseases; they often mimic primary inner ear disorders such as Menière's disease and mainly affect both ears simultaneously. Awareness of inner ear involvement in systemic autoimmune diseases is essential for the good response shown to appropriate treatment. However, it is often misdiagnosed due to variable clinical presentation, limited knowledge, sparse evidence, and lack of specific diagnostic tests. The aim of this review is to analyse available evidence, often only reported in the form of case reports due to the rarity of some of these conditions, of the different clinical presentations of audiological and vestibular symptoms in systemic autoimmune diseases.

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“…Systemic lupus erythematosus (SLE) has been associated with an increased risk of sudden SNHL compared with the general population. 2 There have been published cases reporting this. Khalidi et al reported a case of SNHL in a patient with SLE that was actually treated with a combination of steroids and azathioprine with some degree of success.…”

Section: Discussionmentioning

confidence: 97%

Progressive, reversible sensorineural hearing loss caused by azathioprine

2014

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Objective: This paper describes the first reported case of progressive sensorineural hearing loss caused by azathioprine, which was reversed on stoppage of the drug.Case report: A female patient with previously normal hearing presented with progressive sensorineural hearing loss after being started on azathioprine. Otological and neurological examination findings were unremarkable. After stopping the drug, the patient reported an improvement in hearing, which was confirmed on pure tone audiometry.Conclusion: This previously unreported side effect of azathioprine is highlighted in order to increase clinical awareness. Early recognition of this adverse effect is important to minimise the possibility of permanent sensorineural hearing loss.

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Risk of Sudden Sensorineural Hearing Loss in Patients with Systemic Lupus Erythematosus: A Population-Based Cohort Study

Cited by 42 publications

References 35 publications

Sudden Sensorioneural Hearing Loss and Autoimmune Systemic Diseases

Sudden Sensorioneural Hearing Loss and Autoimmune Systemic Diseases

Audiovestibular Symptoms in Systemic Autoimmune Diseases

Progressive, reversible sensorineural hearing loss caused by azathioprine

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