Title:Sudden Sensorineural Hearing Loss in Systemic Lupus Erythematosus and Antiphospholipid Syndrome: A Clinical Review
Volume: 16
Issue: 2
Author(s): Julia L. Riera , María del R. Maliandi, Jorge L. Musuruana and Javier A. Cavallasca *
Affiliation:
- Section of Rheumatology and Autoimmune Diseases, Hospital JB Iturraspe, Santa Fe,Argentina
Keywords:
Systemic lupus erythematosus, antiphospholipid syndrome, sudden sensorineural, hearing loss, corticosteroids,
anticoagulation.
Abstract:
Background: Sudden sensorineural hearing loss (SSNHL) is defined as a sudden loss of
hearing, usually unilateral, of more than 30 dB in 3 contiguous frequencies of the tonal audiometry.
SSNHL estimates an incidence ranging from 5 to 20 per 100.000 people per year. In approximately
75% of cases, a cause cannot be identified. However, it could be a clinical manifestation of Systemic
lupus erythematosus (SLE) and Antiphospholipid Syndrome (APS).
Objective: This review will focus on the clinical presentation, diagnosis, and management of the
SLE and APS associated SSNHL.
Methods: We searched in PubMed, Scopus, Lilacs, and Cochrane reviewing reports of Sudden sensorineural
hearing loss in SLE and/or APS. Articles written in English and Spanish, and were available
in full text, were included.
Results: In patients with SLE, bilateral involvement was frequent. Antiphospholipid antibodies
were positive in the majority of the patients. Corticosteroids were the mainstay of the treatment.
The auditory prognosis was poor with total hearing loss recovery reached in only 22% of patients.
On the other hand, most of the patients with SSNHL and APS were males and presented associated
symptoms such as vertigo, tinnitus and/or headache, 75% had bilateral disease. Lupus anticoagulant
and aCL were found in equal proportions, all patients were anticoagulated, and aspirin was associated
in 25% of the cases. Complete resolution or improvement of symptoms was observed in
25% of the patients.
Conclusion: Sudden sensorineural hearing loss, can be a clinical feature of SLE and APS. Treating
physicians should be aware of this devastating complication, especially when bilateral involvement
occurs.
