Serviço de Reumatologia, Hospital Universitário Evangélico Mackenzie, Curitiba, PR, Brazil.
Núcleo de Pesquisa em Doenças Crônicas não Transmissíveis (NUPEN), School of Nutrition from the Federal University of Bahia, Salvador, Bahia, Brazil.
Autoimmun Rev. 2024 Oct;23(10):103606. doi: 10.1016/j.autrev.2024.103606. Epub 2024 Aug 28.
Chronic fatigue syndrome (CFS), fibromyalgia (FM), silicone breast implants (SBI), Coronavirus-19 infectious disease (COVID), COVID-19 vaccination (post-COVIDvac-syndrome), Long-COVID syndrome (PCS), sick-building syndrome (SBS), post-orthostatic tachycardia syndrome (PoTS), and autoimmune/ inflammatory syndrome induced by adjuvants (ASIA) are a cluster of poorly understood medical conditions that have in common a group of ill-defined symptoms and dysautonomic features. Most of the clinical findings of this group of diseases are unspecific, such as fatigue, diffuse pain, cognitive impairment, paresthesia, tachycardia, anxiety, and depression. Hearing disturbances and vertigo have also been described in this context, the underlying pathophysiologic process for these conditions might rely on autonomic autoimmune dysbalance. The authors procced a literature review regarding to hearing and labyrinthic disturbances in CSF, FM, SBI, COVID, post-COVIDvac-syndrome, PCS, SBS, POTS, and ASIA. The PRISMA guidelines were followed, and the literature reviewed encompassed papers from January 1990 to January 2024. After the initial evaluation of the articles found in the search through Pubmed, Scielo and Embase, a total of 172 articles were read and included in this review. The prevalence of hearing loss, dizziness, vertigo and tinnitus was described and correlated with the diseases investigated in this study. There are great variability in the frequencies of symptoms found, but cochlear complaints are the most frequent in most studies. Vestibular symptoms are less reported. The main pathophysiological mechanisms are discussed. Direct effects of the virus in the inner ear or nervous pathways, impaired vascular perfusion, cross-reaction or autoimmune immunoreactivity, oxidative stress, DNA methylation, epigenetic modifications and gene activation were implicated in the generation of the investigated symptoms. In clinical practice, all patients with these autoimmune conditions who have any audiological complaint an ENT consultation followed by an audiometry are needed.
慢性疲劳综合征（CFS）、纤维肌痛症（FM）、硅胶乳房植入物（SBI）、新型冠状病毒病（COVID）、COVID-19 疫苗接种后综合征（post-COVIDvac-syndrome）、长 COVID 综合征（PCS）、病态建筑综合征（SBS）、体位性心动过速综合征（PoTS）和疫苗佐剂诱发的自身免疫/炎症综合征（ASIA）是一组尚未完全明确的医学病症，它们共同具有一组定义不明确的症状和自主神经功能紊乱特征。这些疾病组的大多数临床发现都是非特异性的，如疲劳、弥漫性疼痛、认知障碍、感觉异常、心动过速、焦虑和抑郁。在这种情况下，还描述了听力障碍和眩晕，这些病症的潜在病理生理过程可能依赖于自主神经自身免疫失衡。作者对 CSF、FM、SBI、COVID、post-COVIDvac-syndrome、PCS、SBS、POTS 和 ASIA 中与听力和迷路障碍相关的文献进行了综述。遵循 PRISMA 指南，文献综述涵盖了 1990 年 1 月至 2024 年 1 月期间的论文。通过 Pubmed、Scielo 和 Embase 进行初步评估后，共阅读并纳入了 172 篇文章。描述了听力损失、头晕、眩晕和耳鸣的患病率，并与本研究中调查的疾病相关联。在所发现的症状频率中存在很大的差异，但在大多数研究中，耳蜗投诉是最常见的。前庭症状报告较少。讨论了主要的病理生理机制。病毒对内耳或神经通路的直接影响、血管灌注受损、交叉反应或自身免疫反应性、氧化应激、DNA 甲基化、表观遗传修饰和基因激活都被认为与所研究的症状的产生有关。在临床实践中，所有患有这些自身免疫性疾病且有任何听力投诉的患者都需要进行耳鼻喉科咨询和听力测试。
