Roverano Susana, Cassano Gustavo, Paira Sergio, Chiavarini Jorge, Graf César, Rico L, Heredia C
Department of Rheumatology, Hospital José María Cullen, Santa Fe, Argentina.
J Clin Rheumatol. 2006 Oct;12(5):217-20. doi: 10.1097/01.rhu.0000242777.71604.69.
Hearing loss can accompany systemic lupus erythematosus (SLE). The purpose of this study was to evaluate the prevalence of asymptomatic sensorineural hearing loss (ASNHL) in patients with SLE.
Thirty-one unselected consecutive female patients with SLE (American College of Rheumatology criteria, 1982) were evaluated (in a prospective and descriptive study) for evidence of hearing abnormalities. Twenty-five healthy age-matched women served as controls. All patients and control groups underwent both a normal tympanoscopy and an audiometric testing as a prerequisite to be included in the study.
Patients with SLE had a mean age of 35 years (range, 19-64 years) and the follow-up time (median) was 48 months (range, 4-180 months). One of 31 patients was excluded because of middle ear infectious disease. Of the remaining 30 patients, 21 (70%) had impaired hearing; 20 (66%) had sensorineural loss at high frequencies in a bilateral and symmetric way, and one had conductive alteration. Ten patients had normal audiometric studies. Four women in the control group had alterations of the audiometric tests: 3 patients had conductive alteration and the other one had bilateral ASNHL. No statistically significant correlation was found among the presence of ASNHL, the detection of antiphospholipid antibodies, and the treatment with hydroxychloroquine. Also, no correlation was observed between impaired hearing and SLE activity.
If it can be established how often this ASNHL progresses to a clinical problem, it can be important that, as part of initial studies, patients with SLE undergo audiometric tests.
听力损失可能伴随系统性红斑狼疮(SLE)出现。本研究的目的是评估SLE患者中无症状性感音神经性听力损失(ASNHL)的患病率。
对31例连续入选的未经过挑选的女性SLE患者(符合1982年美国风湿病学会标准)进行评估(前瞻性描述性研究),以寻找听力异常的证据。25名年龄匹配的健康女性作为对照。所有患者和对照组均接受正常的鼓室镜检查和听力测试,这是纳入本研究的前提条件。
SLE患者的平均年龄为35岁(范围19 - 64岁),随访时间(中位数)为48个月(范围4 - 180个月)。31例患者中有1例因中耳感染性疾病被排除。其余30例患者中,21例(70%)听力受损;20例(66%)高频感音神经性听力损失呈双侧对称,1例有传导性改变。10例患者听力测试正常。对照组中有4名女性听力测试有改变:3例有传导性改变,另1例有双侧ASNHL。在ASNHL的存在、抗磷脂抗体的检测和羟氯喹治疗之间未发现统计学上的显著相关性。此外,听力受损与SLE活动之间也未观察到相关性。
如果能够确定这种ASNHL发展为临床问题的频率,那么作为初始研究的一部分,SLE患者进行听力测试可能很重要。