Objectives/Hypothesis Antimalarial drugs (chloroquine and hydroxychloroquine) are widely used for the treatment of systemic lupus erythematosus (SLE). However, these drugs may have side effects such as hearing loss. This study aimed to describe the hearing function in SLE patients using antimalarials. Secondarily, this study aimed to investigate whether SLE causes hearing loss and if there are any serological or clinical aspects of this diseases associated with inner ear damage. Study Design Cross‐sectional study. Methods This study included 84 individuals (43 SLE patients and 41 controls) with audiometry and tympanometry tests. Epidemiological, clinical, serological, and treatment profiles of SLE patients were extracted from the charts. Results SLE patients had more sensorineural hearing loss than controls (23.2% vs. 0; P = .001). Pure‐tone averages in SLE patients using antimalarials and not using antimalarials were similar (8.75 vs. 8.75; P = .63). At 8,000 Hz, antimalarial dug nonusers performed worse than users (10.00 vs. 22.50; P = .03). Tympanometry was normal in all participants. SLE serological and clinical profiles in patients with and without hearing loss were the same (all P = nonsignificant). Conclusions There is a high prevalence of hearing loss in SLE that is not affected by antimalarial drug use. Level of Evidence 3b Laryngoscope , 2020
Background:Systemic lupus erythematosus(SLE) is a systemic disease that may affect the inner ear.Objectives:To study hearing function in SLE and its possible association with clinical and serological profile as well as with antimalarial use.Methods:Cross sectional study of 84 individuals(43 SLE patients and 41 controls) with audiometry and impedanciometry tests. Epidemiological, clinical, serological and treatment profile of SLE patients were extracted from the charts.Results:SLE patients had more sensorineural hearing loss than controls(23.2% vs 0; p=0.001). The hearing loss was seen at 250 Hz, 500 Hz, 1000 Hz and 4000 Hz. No bone conduction impairment was observed. Serological and clinical profile in patients with and without hearing loss was the same (all p=ns). Patients on antimalarial had the same prevalence of hearing loss than those not using it but at 8.000 Hz, antimalarial non-users performed worse than users(p=0.03).Conclusion:There is a high prevalence of hearing loss in SLE that is not affected by disease characteristics neither by antimalarial use.References[1] - Di Stadio A, Ralli M. Systemic Lupus Erythematosus and hearing disorders: Literature review and meta-analysis of clinical and temporal bone findings. J Int Med Res. 2017; 45:1470-80.[2] - Ralli M, D’Aguanno V, Di Stadio A, De Virgilio A, Croce A, Longo L, et al. Audiovestibular symptoms in systemic autoimmune diseases. J Immunol Res. 2018; 2018: 5798103. eCollection 2018.[3] - Jourde-Chiche N, Mancini J, Dagher N, Taugourdeau S, Thomas G, Brunet C, et al. Antimalarial ototoxicity: an underdiagnosed complication? A study of spontaneous reports to the French Pharmacovigilance Network. Ann Rheum Dis. 2012; 71: 1586.TABLE 1 Comparison of median auditory perception(in decibels) according to the studied frequency of the sound, speech recognition threshold and tympanometry between SLE patients and controlsSLE patients(86 ears)Controls(82 ears)pMAC8.75 (5.00-13.75)10.00 (5.93-12.50)0.54AC 250 Hz10.00 (5.00-15.00)15.00 (10.00-20.00)< 0.0001AC 500 Hz10.00 (5.00-10.00)12.50 (5.00-20.00)< 0.0001AC 1.000 Hz5.00 (0-10.00)5.00 (5.00-15.00)0.03AC 2.000 Hz5.00 (0-15.00)10.00 (5.00-15.00)0.65AC 3.000 Hz10.00 (5.00-15.00)10.00 (5.00-15.00)0.40AC 4.000 Hz15.00 (5.00-20.00)10.00 (5.00-15.00)0.002AC 6.000 Hz15.00 (8.75-25.00)15.00 (10.00-25.00)0.37AC 8.000 Hz15.00 (10.00-30.00)10.00 (8.75-15.00)0.09SRT (%)96.0 (96.0-100.0)100.0 (100.0-100.0)< 0.0001TIMP0 (0-0)0 (0-0)0.99MAC= mean air conduction; Hz=Hertz, SRT= speech recognition threshold; TIMP= tympanometry.TABLE 2 Comparison of clinical data, auditory perception (in decibels) according to the studied frequency of the sound, speech recognition threshold and tympanometry in SLE patients using and not using antimalarialsWith antimalarialsN= 74 earsWithout antimalarialsN=12 earsPMean Age (years) (SD)46.4±12.740.9±13.90.22Median Disease duration (years)8.50 (5.00-14.25)12.00 (8.25-21.25)0.19MAC8.75 (5.00-13.75)8.75 (5.31-13.44)0.63AC 250 Hz10.00 (5.00-18.75)10.00 (5.00-15.00)0.81AC 500 Hz10.00 (5.00-10.00)7.50 (5.00-...
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