Sensorineural hearing disorders in systemic lupus erythematosus. A controlled study

Abstract

Objective: Hearing abnormalities have been described in several connective tissue diseases, but relevant data in systemic lupus erythematosus (SLE) is very insufficient. We therefore prospectively evaluated forty unselected consecutive female SLE patients for evidence of audiovestibular dysfunction and compared the results with those of 65 age-matched healthy women.

Methods: Patients and controls were separated into five age groups, i.e. 16-29 years, 30-39, 40-49, 50-59 and 60-69 years. Evaluation included pure tone audiometry thresholds at octave frequencies from 125Hz to 8000Hz, tympanometry and the stapedial reflex test in both ears. In particular, SLE activity, the presence of vasculitis and severe kidney and nervous system involvement, and serum levels of anti-ds-DNA antibodies and C3 and C4 were recorded.

Results: A statistically significant decrease in hearing acuity at low frequencies (125-500Hz) was found in the patients aged 16-59 compared with the controls, whereas in the first group of young patients (16-29) a similar decrease was observed in the high frequencies as well. No correlation was found between these abnormalities and any parameter of the underlying disease.

Conclusion: With regard to the high frequencies, our results suggest that young SLE patients exhibit a "premature aging" of the inner ear which eventually stabilizes. On the contrary, at low frequencies there is a regular decrease in acuity in all groups (except for the elderly patients: 60-69), which may indicate a subclinical vestibular hydrops. This could be accounted for by an autoimmune process in the inner ear, quite possible in SLE.