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

Abstract

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.

Work-Related Noise Exposure in a Cohort of Patients with Chronic Tinnitus: Analysis of Demographic and Audiological Characteristics

“…Older individuals had worse hearing thresholds and experienced tinnitus for a longer time. This is consistent with the literature, which reports greater incidence of tinnitus and hearing loss with age [ 24 , 25 , 26 , 68 , 69 , 74 ]. When comparing older (>60-year-old) individuals in the two groups, significantly worse hearing was found in patients in the HIGH-RISK group, suggesting that such a trend is accelerated in patients exposed to noise in general and, more specifically, to noisy working environments [ 68 , 69 ].…”

“…Approximately 2% of the population in industrialized countries is reported to experience incessant tinnitus [ 15 ]. Tinnitus may have audiological, somatic or psychological bases [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]; risk factors for tinnitus include hearing loss, exposure to loud noise and increasing age [ 25 , 26 , 27 ]. Furthermore, patients often report worsening of tinnitus with stress; therefore, workers subject to high job stress may have an increased risk of tinnitus [ 28 , 29 , 30 ].…”

Macrophage activation syndrome as an initial presentation of systemic lupus erythematosus with sensorineural hearing loss in a young male patient

“…In a meta-analysis, the prevalence of sensorineural hearing loss was discovered in 6%–70% of SLE patient. An autoimmune response, immune complex deposition and cytotoxic damage contributed to the damage of inner ear 10. Sensorineural hearing loss has been observed in haemophagocytic syndrome; however, the exact mechanism is not clearly understood.…”

Immune-mediated Sensorineural Hearing Loss: Patho-Mechanisms and Therapeutic Strategies

“…Hypoxia increases generation of reactive-oxygen species, which in turn damages the hair cells and spiral ganglion. [14] Sudden SNHL has been reported to result due to temporary reduction of blood flow in the inner ear (vasculitis), where partial or complete recovery is possible after restoration of blood flow; persistent vasculitis is known to permanently damage hearing. [15] The cytokines that play a crucial role in ISNHL are TNF-α, IL-1β, and IL-6; [16][17][18][19][20] NLRP3 inflammasomemediated upregulation of IL-1β plays an important role in immune-mediated damage (Figure 1).…”