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Yélamos Lorente MÁ, Perez-Carpena P, Lopez-Escamez JA. A Systematic Review on Heritability of Sudden Sensorineural Hearing Loss. Laryngoscope 2024; 134:3447-3457. [PMID: 38270208 DOI: 10.1002/lary.31308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/23/2023] [Accepted: 01/03/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE To assess the evidence supporting the heritability and genetic basis of sudden sensorineural hearing loss (SSNHL). DATA SOURCE Records were extracted from PubMed, Scopus, and Cochrane databases. REVIEW METHODS The protocol was registered on PROSPERO (CRD42022357389) and includes a systematic review on the genetic contribution to SSNHL. The search strategy yielded 1.483 articles from electronic databases. After quality assessment, 34 records were selected, including 369.650 patients with SSNHL from nine prevalence studies, two familial aggregation studies, one twin study, and 22 genetic studies. The prevalence of SSNHL was calculated from data on its incidence from population-based studies (period prevalence). To evaluate the heritability of SSNHL, the sibling recurrence risk ratio (λs) was calculated, by comparing the prevalence of SSNHL among siblings within the same generation to the estimated prevalence in the overall population. Genetic variants were grouped, based on the pathological mechanism related to SSNHL. RESULTS The prevalence of SSNHL ranged from 0.1% to 0.0003% in America to 0.12%-0.0093% in Asia. The estimated sibling recurrence risk ratio for SSNHL (λs = 20.8-83.3) supports a significant familial aggregation. Although several genetic variants were reported to be associated with SSHL in controlled studies, neither was replicated in an independent cohort. CONCLUSIONS Evidence supporting heritability of SSNHL is limited to epidemiological studies showing prevalence differences across different populations and familial aggregation. Genetic studies are of low quality and they lack replication cohort to confirm their findings. According to its low prevalence, exome or genome sequencing familial-based studies are needed to identify rare genetic variants in SSNHL. LEVEL OF EVIDENCE NA Laryngoscope, 134:3447-3457, 2024.
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Affiliation(s)
- Mª Á Yélamos Lorente
- Division of Otolaryngology, Department of Surgery, University of Granada, Granada, Spain
- Family and Community Medicine, Zaidin Sur Health Center (Granada), San Cecilio University Hospital, Granada, Spain
| | - Patricia Perez-Carpena
- Division of Otolaryngology, Department of Surgery, University of Granada, Granada, Spain
- Department of Otolaryngology, Instituto de Investigación Biosanitaria, ibs.Granada, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras, CIBERER, Madrid, Spain
| | - Jose A Lopez-Escamez
- Division of Otolaryngology, Department of Surgery, University of Granada, Granada, Spain
- Department of Otolaryngology, Instituto de Investigación Biosanitaria, ibs.Granada, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Meniere's Disease Neuroscience Research Program, Faculty of Medicine & Health, School of Medical Sciences, The Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
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Chen JJ, Hsu CW, Chen YW, Chen TY, Zeng BS, Tseng PT. Audiovestibular Dysfunction in Systemic Lupus Erythematosus Patients: A Systematic Review. Diagnostics (Basel) 2024; 14:1670. [PMID: 39125546 PMCID: PMC11311441 DOI: 10.3390/diagnostics14151670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/25/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024] Open
Abstract
Audiovestibular dysfunction in patients with systemic lupus erythematosus has been underestimated for decades. Systemic lupus erythematosus can affect both the auditory and vestibular systems simultaneously. Several potential pathophysiological mechanisms behind systemic lupus erythematosus-related audiovestibular dysfunction have been proposed, including antibody-mediated immune responses, cell-mediated cytotoxicity, immune complex deposition in microvessels, central involvement in the audiovestibular pathway, and ototoxicity from medications used in systemic lupus erythematosus treatment. Currently available tests to evaluate audiovestibular function in systemic lupus erythematosus patients are neither specific nor sensitive. Nevertheless, there is no consensus regarding the efficacy of treatments for audiovestibular dysfunction in such patients. In this systematic review, we electronically searched the PubMed, Embase, ClinicalKey, Web of Science, and ScienceDirect platforms to find eligible articles. The first inspection date was on 29 December 2023 and the final update search date was on 11 June 2024. Further, we rated the quality of the included articles with Newcastle-Ottawa Scale. Based upon the aforementioned systematic review process, we have summarized the currently available evidence on the characteristics, pathophysiology, examination, and treatment of audiovestibular dysfunction related to systemic lupus erythematosus. Furthermore, we have proposed a specific steroid treatment protocol to manage audiovestibular dysfunction related to systemic lupus erythematosus. Audiovestibular dysfunction related to systemic lupus erythematosus may be responsive to adequate treatments, potentially allowing for reversibility if the disease is recognized and managed in a timely manner. Therefore, to provide clinically relevant evidence to clinicians, we have organized this literature review article to summarize the available evidence on the characteristics, pathophysiology, examination, and treatment of audiovestibular dysfunction in patients with systemic lupus erythematosus. Finally, based on our modified steroid treatment protocol, we would like to provide a new treatment strategy to clinicians to manage systemic lupus erythematosus-related audiovestibular dysfunction.
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Affiliation(s)
- Jiann-Jy Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung 81166, Taiwan; (J.-J.C.); (Y.-W.C.)
- Department of Otorhinolaryngology, E-Da Cancer Hospital, I-Shou University, Kaohsiung 80756, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung 81166, Taiwan; (J.-J.C.); (Y.-W.C.)
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan;
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Bing-Syuan Zeng
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 80424, Taiwan
- Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan
| | - Ping-Tao Tseng
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung 81166, Taiwan; (J.-J.C.); (Y.-W.C.)
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 413305, Taiwan
- Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung 804201, Taiwan
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Oussoren FK, Schermer TR, van Leeuwen RB, Bruintjes TD. Cardiovascular Risk Factors, Cerebral Small Vessel Disease, and Subsequent Risk of Stroke in Patients with Idiopathic Sudden Sensorineural Hearing Loss: Systematic Review and Meta-Analyses of the Current Literature. Audiol Neurootol 2023; 29:1-29. [PMID: 37557093 PMCID: PMC10836643 DOI: 10.1159/000530686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/04/2023] [Indexed: 08/11/2023] Open
Abstract
Vascular involvement in the pathophysiology of idiopathic sudden sensorineural hearing loss (iSSNHL) has been previously proposed. The objective of this study was to perform a systematic review of the current literature and conduct meta-analyses to evaluate associations between cardiovascular risk factors, cerebral small vessel disease, and subsequent stroke after presentation with iSSNHL. Three systematic literature reviews and meta-analyses were conducted using PubMed, Embase, and CINAHL. All studies investigating associations between iSSNHL and the cardiovascular risk factors: body mass index (BMI), diabetes mellitus, hyperlipidemia, hypertension, medical history of myocardial infarction (MI), smoking, the degree of white matter hyperintensities, and incidence of stroke were included. Adhering to the PRISMA guidelines, two independent reviewers reviewed the articles and assessed risk of bias. The cardiovascular risk factors of abnormal BMI, diabetes, hypertension, total cholesterol, low-density lipoprotein cholesterol, and a medical history of MI were significantly associated with iSSNHL. The adjusted hazard ratio of a higher degree of white matter hyperintensities was 0.70 (95% CI 0.44, 1.12). Patients with iSSNHL showed a higher risk of stroke compared to controls, with hazard ratios ranging from 1.22 up to 4.08. Several cardiovascular risk factors are more frequently present in patients with iSSNHL than in the general population. The degree of white matter hyperintensities does not appear to be increased in patients with iSSNHL, while the risk of stroke following ISSNHL is increased. Prospective studies with larger study populations are needed to confirm the associations between generalized cardiovascular disease and iSSNHL and to assess whether these patients benefit from cardiovascular risk management to prevent future cardiovascular and cerebrovascular disease.
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Affiliation(s)
- Fieke K. Oussoren
- Department of Otorhinolaryngology, Leiden University Medical Center, Leiden, The Netherlands
- Apeldoorn Dizziness Centre, Gelre Hospital, Apeldoorn, The Netherlands
| | - Tjard R. Schermer
- Apeldoorn Dizziness Centre, Gelre Hospital, Apeldoorn, The Netherlands
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Tjasse D. Bruintjes
- Department of Otorhinolaryngology, Leiden University Medical Center, Leiden, The Netherlands
- Apeldoorn Dizziness Centre, Gelre Hospital, Apeldoorn, The Netherlands
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Ger TY, Lien KH, Chi CC. Association of Psoriasis With Hearing Loss: A Systematic Review and Meta-Analysis. J Cutan Med Surg 2023; 27:330-339. [PMID: 37231542 DOI: 10.1177/12034754231177613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND The relation between psoriasis and hearing loss has been unclear. OBJECTIVE To investigate the association of psoriasis with hearing loss. METHODS We searched MEDLINE and Embase on 12th November 2022 for studies on the association between psoriasis and hearing loss. We conducted a random-effects model meta-analysis to calculate pooled mean difference (MD) in the pure tone thresholds, pooled odds ratio for sensorineural hearing loss, and pooled hazard ratio for sudden sensorineural hearing loss related to psoriasis. RESULTS We included 12 case-control/cross-sectional and 3 cohort studies with 202,683 subjects. Psoriasis was associated with hearing loss at 500 Hz (pooled MD 2.21, 95% CI (CI) 0.13 to 4.29), 1000 Hz (pooled MD 2.97, 95% CI 1.01 to 4.93), 2000 Hz (pooled MD 5.13, 95% CI 2.45 to 7.82), 4000 Hz (pooled MD 9.3, 95% CI 5.1 to 13.51), and 6000 Hz (pooled MD 11.04, 95% CI 5.05 to 17.03). Patients with psoriasis had increased odds for sensorineural hearing loss (pooled odds ratio 3.85, 95% CI 1.07-13.9) and risk for sudden sensorineural hearing loss (pooled hazard ratio 1.45; 95% CI 1.22-1.71). CONCLUSION Psoriasis is associated with hearing loss, especially at high frequencies.
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Affiliation(s)
- Tzong-Yun Ger
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Kuang-Hsu Lien
- Department of Otolaryngology - Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Chi Chi
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Characteristics of Hearing Loss in Patients with Systemic Lupus Erythematosus. J Clin Med 2022; 11:jcm11247527. [PMID: 36556147 PMCID: PMC9785353 DOI: 10.3390/jcm11247527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/08/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To investigate the clinical characteristics of hearing loss (HL) in patients with systemic lupus erythematosus (SLE) and its related factors. METHODS Ninety-one hospitalized SLE patients and thirty healthy controls were enrolled. All subjects completed pure tone audiometry (PTA), extended high frequency audiometry (EHFA) and distortion product otoacoustic emission (DPOAE) to assess hearing function. SLE patients were divided into two groups according to the presence or absence of HL, and the risk factors of HL were determined by multivariate logistic regression. RESULTS The incidence of HL was 27.47% in SLE patients, significantly higher than in the control group (3.3%) and most cases were mild-to-moderate, bilateral and predominantly sensorineural. Compared with the control group, the hearing thresholds of SLE patients increased significantly in the middle and high frequencies starting from 2000 Hz. Even though the PTA test results were normal, the EHFA test results showed significant differences in hearing impairment between SLE patients and normal controls. For patients with abnormal PTA results, the signal-to-noise ratio (SNR) in DPOAE was markedly reduced, and the pass rate was also decreased. The Systemic Lupus International Collaborating Clinics Damage Index (SDI, OR 9.13) and secondary Sjögren's syndrome (sSS, OR 8.20) were identified as independent associated factors for HL, and there was no difference in PTA and EHFA at all frequencies between hydroxychloroquine users and non-users. CONCLUSIONS HL is not rare in SLE patients, and EHFA can help identify early hearing impairment. Having a high SDI score and secondary Sjögren's syndrome may predict the presence of HL in SLE.
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Brisse M, Fernández-Alarcón C, Huang Q, Kirk N, Schleiss MR, Liang Y, Ly H. Hearing loss in outbred Hartley guinea pigs experimentally infected with Pichinde virus as a surrogate model of human mammarenaviral hemorrhagic fevers. Virulence 2022; 13:1049-1061. [PMID: 35758052 PMCID: PMC9794012 DOI: 10.1080/21505594.2022.2087948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Lassa fever (LF) is a neglected tropical disease that is caused by Lassa virus (LASV), a human hemorrhagic fever-causing mammarenavirus. A notable sequela of LF is sensorineural hearing loss (SNHL) that can develop in about 33% of the patients. Animal models of LF-associated SNHL have been limited in size and scope because LASV is a biosafety level 4 (BSL4) pathogen that requires its handling in a high biocontainment laboratory. In this report, we describe the development of an alternative arenavirus hearing loss model by infecting outbred Hartley guinea pigs with a virulent strain (rP18) of the Pichinde virus (PICV), which is a guinea pig-adapted mammarenavirus that has been used as a surrogate model of mammarenaviral hemorrhagic fevers in a conventional (BSL2) laboratory. By measuring auditory brainstem response (ABR) throughout the course of the virulent rP18 PICV infection, we noticed that some of the animals experienced an acute but transient level of hearing loss. Cochleae of hearing-impaired animals, but not of controls, had demonstrable viral RNA by quantitative RT-PCR, indicating the presence of virus in the affected inner ear with no overt histopathological changes. In contrast, neither the outbred Hartley guinea pigs infected with a known avirulent strain (rP2) of PICV nor those that were mock-infected showed any evidence of hearing loss or viral infection of the inner ear. This is the first report of an immunocompetent small animal model of mammarenavirus-induced hearing loss that can be used to evaluate potential therapeutics against virus-induced hearing impairment under a conventional laboratory setting.
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Affiliation(s)
- Morgan Brisse
- Biochemistry, Molecular Biology and Biophysics Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | | | - Qinfeng Huang
- Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | - Natalie Kirk
- Comparative and Molecular Biosciences Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | - Mark R. Schleiss
- Department of Pediatrics, School of Medicine University of Minnesota, Twin Cities, Minnesota, USA
| | - Yuying Liang
- Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | - Hinh Ly
- Biochemistry, Molecular Biology and Biophysics Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Comparative and Molecular Biosciences Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA,CONTACT Hinh Ly
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Sensorineural Hearing Loss in Sjögren’s Syndrome. Int J Mol Sci 2022; 23:ijms231911181. [PMID: 36232483 PMCID: PMC9569624 DOI: 10.3390/ijms231911181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/20/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
Sjögren’s syndrome is a chronic autoimmune disease characterized by systemic dysfunction of exocrine glands, mainly the salivary and lachrymal glands. Sjögren’s syndrome consists of two forms: primary Sjögren’s syndrome, which is characterized by dry eyes and dry mouth without autoimmune diseases; and secondary Sjögren’s syndrome, which is characterized by symptoms associated with other autoimmune diseases, such as systemic lupus erythematosus. Disease severities vary considerably from mild glandular dryness to severe glandular involvement with numerous extraglandular and systemic features. Sensorineural hearing loss is sometimes observed in both primary and secondary Sjögren’s syndrome. This review article consists of (1) Pathology of Sjögren’s syndrome, (2) Clinical manifestation of Sjögren’s syndrome, (3) Autoimmune inner ear disease, (4) Histoanatomical features of the inner ear, (5) Immunological characteristics of the inner ear, (6) Pathophysiology of autoimmune inner ear disease, (7) Treatment for sensorineural hearing loss in Sjögren’s syndrome, and (8) Future direction. Finally, we introduce a recently developed disease model of salivary gland inflammation and discuss future expectations for the treatment of sensorineural hearing loss in Sjögren’s syndrome.
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Clinical Feature and Prognosis of Sudden Sensorineural Hearing Loss With Rheumatoid Arthritis. Otol Neurotol 2021; 42:e267-e271. [PMID: 33021510 DOI: 10.1097/mao.0000000000002962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Recent publications reported that patients with rheumatoid arthritis (RA) experience an increased risk of suffering sudden sensorineural hearing loss (SSNHL), however, these cases are poorly understood. This study aims to explore the clinical presentations and hearing recovery of SSNHL patients with RA. STUDY DESIGN Retrospective study. SETTING Tertiary medical center. PATIENTS Forty-seven SSNHL patients with RA (RA group) and 431 SSNHL patients without RA (non-RA group) were recruited between April 2015 and June 2019. INTERVENTIONS In the non-RA group, all patients were administrated with oral steroids. In the RA group, 21 patients were treated with oral steroid (OS group) and 26 patients were administrated with intratympanic steroids plus oral steroids (IS+OS group). MAIN OUTCOME MEASURES We explored the clinical features and hearing recovery of SSNHL patients with RA in comparison with patients without RA, we also evaluated the therapeutic effect of combined steroids in SSNHL patients with RA. RESULTS RA group had higher initial hearing loss level (mean 68.5 dB), final hearing threshold (mean 52.3 dB), the rates of profound hearing loss (48.9%), and no recovery (48.9%) than non-RA group (mean 55.1 dB, mean 34.8 dB, 32.9 and 27.6%, all p < 0.05), however, had lower hearing gains (mean 16.1 dB) and the rate of partial recovery (12.8%) than non-RA group (mean 20.3 dB and 28.8%, all p < 0.05). Furthermore, IS+OS group had higher hearing gains (mean 21.1 dB) and lower rate of no recovery (30.8%) than in the OS group (mean 10.0 dB and 71.4%, all p < 0.05). CONCLUSIONS SSNHL patients with RA experienced severe hearing loss and had poor hearing prognosis. IS+OS provide better hearing recovery than OS for this population.
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Paraschou V, Chaitidis N, Papadopoulou Z, Theocharis P, Siolos P, Festas C. Association of systemic lupus erythematosus with hearing loss: a systemic review and meta-analysis. Rheumatol Int 2021; 41:681-689. [PMID: 33533981 DOI: 10.1007/s00296-021-04788-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/12/2021] [Indexed: 11/24/2022]
Abstract
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that can affect virtually any organ, including middle and/or inner ear. The objective of the current systematic review and meta-analysis was to investigate the association of SLE with the different subtypes of hearing loss. This systematic review and meta-analysis was conducted in agreement with the PRISMA guidelines. The review protocol was registered in the PROSPERO international prospective register of systematic reviews ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216353 ). A random effects model meta-analysis was carried out while heterogeneity was appraised by I2. Subgroup analysis and sensitivity analysis were also performed. Nine studies comprising 7,654 SLE patients and 37,244 controls were included in this systematic review. Four of them were rated to a moderate rate of bias, while five of them were rated to a low rate of bias. SLE patients had significantly increased odds of sensorineural hearing loss (SNHL) compared with controls (OR 2.31; 95%CI 1.48-3.60; I2 = 0). SLE patients did not have significantly increased odds of Conductive Hearing Loss (CHL) (OR 1.30; 95% CI 0.23-7.45; I2 = 0). Only one study reported on the outcome of Mixed Hearing Loss (MHL) (3 events in SLE group vs. 0 events in control group). Subgroup analysis, based on study design and detection method of hearing loss also showed significantly increased odds of SNHL in SLE patients. The significantly increased odds of SNHL in SLE persisted even after sensitivity analysis. In conclusion, SLE is significantly associated with SNHL; SLE is not associated with CHL, while, due to lack of data, we could not reach a conclusion regarding the odds of MHL in SLE patients. Pure tone audiometry as a screening test and follow-up test in SLE patients could be of essence. Management and prognosis of hearing loss in SLE patients should be discussed.
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Affiliation(s)
| | | | - Zoi Papadopoulou
- 3rd Department of Pediatrics, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Pavlos Siolos
- 1st Department of Pediatrics, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Charalampos Festas
- Department of Otorhinolaryngology, 401 General Military Hospital of Athens, Athens, Greece
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Psoriasis Increases the Risk of Sudden Sensorineural Hearing Loss: A Longitudinal Follow Up Study Using a National Sample Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249310. [PMID: 33322823 PMCID: PMC7764529 DOI: 10.3390/ijerph17249310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 12/27/2022]
Abstract
Psoriasis is a well-known immune-mediated disease. Its autoimmune pathophysiology is consistent with the immune-mediated systemic vascular hypothesis regarding the pathogenesis of sudden sensorineural hearing loss (SSNHL). The purpose of our study was to investigate whether psoriasis affects the prevalence of SSNHL in all age groups matched by age, sex, income, and region of residence. Korean Health Insurance Review and Assessment Service-National Patient Samples were collected from 2002 to 2013. A 1:4 matched psoriasis group (n = 12,864) and control group (n = 51,456) were selected. The crude (simple) and adjusted (Charlson comorbidity index) hazard ratios (HR) for psoriasis and SSNHL were analyzed using the stratified Cox proportional hazard model. The incidence of SSNHL was significantly higher in the psoriasis group than in the control group (0.5% vs. 0.4%, p = 0.004). Psoriasis increased the risk of SSNHL (adjusted HR = 1.44, 95% confidence interval (CI) = 1.09–1.90, p = 0.010). In the stratification analysis, the incidence of SSNHL was significantly higher in the 30–59-year-old group than other group SSNHL (adjusted HR = 1.50, 95% CI = 1.06–2.12, p = 0.023). In addition, SSNHL occurred significantly more frequently in men with psoriasis (adjusted HR = 1.70, 95% CI = 1.17–2.49, p = 0.006). Psoriasis increased the risk of SSNHL, and SSNHL was more prevalent in between the age of 30–59-year-olds and men with psoriasis.
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李 熙, 陈 雨, 张 光, 崔 卫. [Immune-mediated sensorineural hearing loss: prevalence and treatment strategies]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2020; 34:663-667. [PMID: 32791649 PMCID: PMC10133116 DOI: 10.13201/j.issn.2096-7993.2020.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Indexed: 06/11/2023]
Abstract
Autoimmune sensorineural hearing loss is a rare clinical entity which accounting for less than 1% in all cases with hearing loss. The prevalence of hearing loss in immune-mediated inner ear diseases, as shown in case reports or single-center statistics, varies widely. We reviewed the current literatures on the association between sensorineural hearing loss and autoimmune diseases, focused on the prevalence of hearing loss in different autoimmune diseases, treatments and challenges.
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Affiliation(s)
- 熙星 李
- 河北医科大学第二医院耳鼻咽喉头颈外科(石家庄,050000)
| | - 雨濛 陈
- 河北医科大学第二医院耳鼻咽喉头颈外科(石家庄,050000)
| | - 光远 张
- 河北医科大学第二医院耳鼻咽喉头颈外科(石家庄,050000)
| | - 卫娜 崔
- 河北医科大学第二医院耳鼻咽喉头颈外科(石家庄,050000)
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Tsai YT, Chang IJ, Hsu CM, Yang YH, Liu CY, Tsai MS, Chang GH, Lee YC, Huang EI, Lin MH, Luan CW. Association between Sudden Sensorineural Hearing Loss and Preexisting Thyroid Diseases: A Nationwide Case-Control Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030834. [PMID: 32013113 PMCID: PMC7037331 DOI: 10.3390/ijerph17030834] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 01/24/2020] [Accepted: 01/26/2020] [Indexed: 01/13/2023]
Abstract
Background: Little evidence is available about the risk of sudden sensorineural hearing loss (SSNHL) in patients with thyroid diseases. We assessed whether a diagnosis of thyroid disease, particularly hyperthyroidism or hypothyroidism, is associated with SSNHL risk in an Asian population. Material and Methods: This case-control study was conducted with population-based data from Taiwan’s National Health Insurance Research Database from January 2000 to December 2013. The case group comprised 3331 adult patients with newly diagnosed SSNHL, and four controls without SSNHL for each case matched by sex, age, monthly income, and urbanization level of residence. Underlying Thyroid diseases were retrospectively evaluated in the case and control groups. Multivariate logistic regression analyses were used to explore relations between thyroid diseases and SSNHL. Results: Of the 3331 cases, 5.7% had preexisting thyroid diseases, whereas only 4.0% of the 13,324 controls had the same condition. After adjustment for sex, age, monthly income, urbanization level of residence, history of hypertension, diabetes mellitus, chronic otitis media, and hyperlipidemia, associations were identified between a history of either hypothyroidism (adjusted odds ratio [AOR], 1.54; 95% CI, 1.02–2.32; p = 0.042) or hyperthyroidism (AOR, 1.41; 95% CI, 1.07–1.85; p = 0.015) and an elevated risk of SSNHL. In subgroup analysis, the correlation between hypothyroidism and increased SSNHL risk remained significant only for patients aged over 50 years (AOR, 1.61; 95% CI, 1.01–2.57; p = 0.045), and that between hyperthyroidism and SSNHL was significant only for female patients (AOR, 1.48; 95% CI, 1.09–2.01; p = 0.012). Treatment for hypothyroidism and hyperthyroidism did not alter the association in subgroup analyses. Conclusion: Preexisting hypothyroidism and hyperthyroidism appear associated with SSNHL susceptibility in Taiwan. Physicians should be wary of this elevated risk of SSNHL among patients with previously diagnosed thyroid dysfunction, especially women and patients aged more than 50 years.
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Affiliation(s)
- Yao-Te Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (Y.-T.T.); (C.-M.H.); (M.-S.T.); (G.-H.C.); (E.I.H.)
| | - I-Jen Chang
- Department of Family Medicine, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;
| | - Cheng-Ming Hsu
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (Y.-T.T.); (C.-M.H.); (M.-S.T.); (G.-H.C.); (E.I.H.)
| | - Yao-Hsu Yang
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (Y.-H.Y.); (C.-Y.L.); (M.-H.L.)
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
| | - Chia-Yen Liu
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (Y.-H.Y.); (C.-Y.L.); (M.-H.L.)
| | - Ming-Shao Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (Y.-T.T.); (C.-M.H.); (M.-S.T.); (G.-H.C.); (E.I.H.)
| | - Geng-He Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (Y.-T.T.); (C.-M.H.); (M.-S.T.); (G.-H.C.); (E.I.H.)
| | - Yi-Chan Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 20445, Taiwan;
| | - Ethan I. Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (Y.-T.T.); (C.-M.H.); (M.-S.T.); (G.-H.C.); (E.I.H.)
| | - Meng-Hung Lin
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (Y.-H.Y.); (C.-Y.L.); (M.-H.L.)
| | - Chih-Wei Luan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chiayi Christian Hospital, Chiayi 61363, Taiwan
- Correspondence:
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Riera JL, Del R Maliandi M, Musuruana JL, Cavallasca JA. Sudden Sensorineural Hearing Loss in Systemic Lupus Erythematosus and Antiphospholipid Syndrome: A Clinical Review. Curr Rheumatol Rev 2019; 16:84-91. [PMID: 31804161 DOI: 10.2174/1573397115666191016101741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 08/20/2019] [Accepted: 10/04/2019] [Indexed: 12/26/2022]
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.
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Affiliation(s)
- Julia L Riera
- Section of Rheumatology and Autoimmune Diseases, Hospital JB Iturraspe, Santa Fe, Argentina
| | - María Del R Maliandi
- Section of Rheumatology and Autoimmune Diseases, Hospital JB Iturraspe, Santa Fe, Argentina
| | - Jorge L Musuruana
- Section of Rheumatology and Autoimmune Diseases, Hospital JB Iturraspe, Santa Fe, Argentina
| | - Javier A Cavallasca
- Section of Rheumatology and Autoimmune Diseases, Hospital JB Iturraspe, Santa Fe, Argentina
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Xie S, Ning H, She Y, Jing Q, Jiang Q, Zhang Y, Mei L, Feng Y, Wu X. Effect of systemic lupus erythematosus and rheumatoid arthritis on sudden sensorineural hearing loss. Laryngoscope 2019; 130:2475-2480. [PMID: 31800112 DOI: 10.1002/lary.28455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Recent reports have identified autoimmune systemic diseases as a significant risk factor for sudden sensorineural hearing loss (SSNHL). We investigated whether systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) were correlated with the hearing recovery of SSNHL. STUDY DESIGN A retrospective study. METHODS Records of 663 SSNHL patients between January 2008 and January 2019 were retrospectively reviewed, including demographic, comorbid diseases, and hearing recovery. Patients were divided into four groups (complete, partial, slight, and no recovery) according to Siegel's criteria and Chinese Medical Association of Otolaryngology (CMAO) criteria. Multinomial logistic regression was performed to evaluate the effects of onset of treatment, initial hearing threshold, audiogram pattern, diabetes mellitus, SLE, and RA on the prognosis of SSNHL according to both criteria. RESULTS Patients in complete recovery, partial recovery, slight recovery, and no improvement were 95 (14.3%), 183 (27.6%), 170 (25.6%), and 215 (32.4%) by Siegel's criteria, and 90 (13.6%), 152 (22.9%), 188 (28.4%), and 233 (35.1%) by CMAO criteria, respectively. Among the four groups, onset of treatment, initial hearing threshold, diabetes mellitus, SLE, RA, and profound audiogram pattern were found to be associated with recovery outcome by both Siegel's criteria and CMAO criteria (P < .05). According to analysis results, presence of SLE, RA, diabetes mellitus and higher initial hearing threshold were significantly correlated with a poor prognosis by both Siegel's criteria and CMAO criteria (P < .05). CONCLUSION Comorbid SLE or RA may negatively affect the prognosis of SSNHL. Lower initial hearing threshold and absence of diabetes mellitus are associated with favorable hearing recovery. LEVEL OF EVIDENCE 4. Laryngoscope, 130:2475-2480, 2020.
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Affiliation(s)
- Shaobing Xie
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, China.,Key Laboratory of Otolaryngology Major Diseases Research of Hunan Province, Changsha, Hunan, China
| | - Hongting Ning
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Yongchuan She
- Department of Otolaryngology Head and Neck Surgery, Changsha Hospital of Traditional Chinese Medicine, Changsha, Hunan, China
| | - Qiancheng Jing
- Department of Otolaryngology Head and Neck Surgery, Changsha Central Hospital, University of South China, Changsha, Hunan, China
| | - Qian Jiang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, China.,Key Laboratory of Otolaryngology Major Diseases Research of Hunan Province, Changsha, Hunan, China
| | - Yanni Zhang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, China.,Key Laboratory of Otolaryngology Major Diseases Research of Hunan Province, Changsha, Hunan, China
| | - Lingyun Mei
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, China.,Key Laboratory of Otolaryngology Major Diseases Research of Hunan Province, Changsha, Hunan, China
| | - Yong Feng
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, China.,Key Laboratory of Otolaryngology Major Diseases Research of Hunan Province, Changsha, Hunan, China
| | - Xuewen Wu
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, China.,Key Laboratory of Otolaryngology Major Diseases Research of Hunan Province, Changsha, Hunan, China
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Jeong J, Lim H, Lee K, Hong CE, Choi HS. High Risk of Sudden Sensorineural Hearing Loss in Several Autoimmune Diseases according to a Population-Based National Sample Cohort Study. Audiol Neurootol 2019; 24:224-230. [PMID: 31550708 DOI: 10.1159/000502677] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 08/12/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE We investigated the risk of sudden sensorineural hearing loss (SSNHL) in patients with autoimmune diseases compared with a control group in a population-based study using a National Health Insurance Service National Sample Cohort data from Korea. METHODS We enrolled autoimmune-disease patients who were ≥20 years of age in 2006 into the autoimmune-disease group, and selected a control group with similar demographic characteristics. We tracked the 2 groups from 2006 to 2015 and compared the proportions of patients who developed SSNHL. RESULTS Of 13,250 patients in the autoimmune-disease group, 145 experienced an SSNHL event (1.09%). Of the 66,250 in the control group, 484 experienced an SSNHL event (0.73%). The SSNHL risk was significantly higher in the autoimmune-disease group than in the control group. SSNHL incidence was significantly higher among patients with antiphospholipid syndrome (APS), multiple sclerosis (MS), rheumatoid arthritis (RA), and connective-tissue diseases including Sjögren syndrome and Behçet disease. In detailed stratified analyses using reinforced additional diagnostic codes, only RA patients had a significantly higher SSNHL incidence than the control group. CONCLUSION The association of several autoimmune diseases with SSNHL was evaluated in this large-scale, population-based, big-data study. The risk of SSNHL was significantly higher in patients with APS, MS, RA, and connective-tissue diseases including Sjögren syndrome and Behçet disease than in patients without autoimmune diseases. SSNHL, in particular, was significantly associated with RA according to detailed analyses using reinforced additional diagnostic codes.
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Affiliation(s)
- Junhui Jeong
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Hyunsun Lim
- Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Kyuin Lee
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Chang Eui Hong
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Hyun Seung Choi
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea,
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Russo FY, Ralli M, De Seta D, Mancini P, Lambiase A, Artico M, de Vincentiis M, Greco A. Autoimmune vertigo: an update on vestibular disorders associated with autoimmune mechanisms. Immunol Res 2019; 66:675-685. [PMID: 30270399 DOI: 10.1007/s12026-018-9023-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The role of the immune system in mediating cochleovestibular pathologies has received increasing attention in recent years. Autoimmune vertigo may be an invalidating condition and may worsen the quality of life of affected patients, especially in the cases of delayed diagnosis. Since the etiopathogenesis is still not clear, also the treatment is not yet completely delineated. According to the clinical presentation, autoimmune vertigo can present as an isolated disorder or in association with systemic autoimmune diseases. The main feature in autoimmune vertigo is the presence of an abnormal immune response, in either absence or presence of systemic autoimmune disease, directed against delicate components of the inner ear. This may determine a functional or anatomical alteration, with an inflammatory reaction often devastating for hearing and balance. Being the exact pathogenesis unknown, the diagnosis of autoimmune vertigo is based either on clinical criteria or on a positive response to steroids. The earlier the diagnosis is made, the sooner the therapy can be installed, giving a chance to the recovery of inner ear damages. Corticosteroids represent the most effective and universally accepted treatment, even if other immunomodulatory drugs are now having a more extensive use. HIGHLIGHTS: Vertigo is relatively frequent in autoimmune diseases; however, it is often misdiagnosed or attributed to central nervous system alterations rather to specific inner ear involvement. Vertigo and other audiovestibular symptoms may be the first manifestation of an autoimmune disease and if correctly addressed could significantly contribute to early diagnosis of the underlying autoimmune disease. Early diagnosis of immune-related vertigo can lead to prompt initiation of targeted therapy with elevate chances of preventing irreversible damages to the inner ear. The presence of alternating phases of well-being and disabling symptoms in patients with vertigo should always been considered, as they could suggest an underlying autoimmune condition.
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Affiliation(s)
- Francesca Yoshie Russo
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy
| | - Daniele De Seta
- Department of Oral and Maxillo-facial Surgery, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy.
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy
| | - Alessandro Lambiase
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy
| | - Marco Artico
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillo-facial Surgery, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy
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Risk of sudden sensorineural hearing loss in patients with dysrhythmia: A nationwide population-based cohort study. PLoS One 2019; 14:e0218964. [PMID: 31242251 PMCID: PMC6594636 DOI: 10.1371/journal.pone.0218964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 06/12/2019] [Indexed: 01/08/2023] Open
Abstract
Objective Whether dysrhythmia is a risk factor of sudden sensorineural hearing loss (SSNHL) remains unclear. In this study, we aimed to investigate the risk of developing SSNHL among patients with dysrhythmia in different age and gender groups by using population-based data in Taiwan. Methods We conducted a matched cohort study by analyzing data between January 2000 and December 2013 obtained from the Taiwan National Health Insurance Research Database. 41,842 newly diagnosed dysrhythmia patients and 83,684 comparison subjects without dysrhythmia were selected from claims. The incidence of sudden sensorineural hearing loss at the end of 2013 was determined in both groups. Univariate and multivariate logistic regression analyses were used to investigate the risk of SSNHL among patients with dysrhythmia. Results The incidence of SSNHL was 1.30-fold higher in the dysrhythmia group compared with the control group (53.2 versus 40.9 per 100,000 person-years), and using Cox proportional hazard regressions, the adjusted hazard ratio (HR) was 1.40 (95% confidence interval [CI], 1.15–1.70). Gender-stratified analysis revealed a significantly higher risk of SSNHL in patients with dysrhythmia than in those without dysrhythmia for both men and women (HR = 1.34, 95% CI = 1.02–1.76, P = 0.039, HR = 1.35, 95% CI = 1.02–1.78, P = 0.035, respectively). Age-stratified analysis revealed remarkable associations between dysrhythmia and SSNHL among those aged less than 40 years and more than 65 years (HR = 2.18, 95% CI = 1.03–4.64, P = 0.043 and HR = 1.54, 95% CI = 1.14–2.09, P = 0.006, respectively). Conclusions Our findings support dysrhythmia as an independent risk factor for SSNHL. Based on the study results, clinicians managing patients with dysrhythmia should be aware of the increased risk of developing SSNHL, especially among patients aged <40 and >65 years, and counsel patients to seek medical advice immediately if they experience any acute change in their hearing ability.
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Lee SY, Kong IG, Oh DJ, Choi HG. Increased risk of sudden sensory neural hearing loss in patients with rheumatoid arthritis: a longitudinal follow-up study using a national sample cohort. Clin Rheumatol 2018; 38:683-689. [DOI: 10.1007/s10067-018-4333-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 10/08/2018] [Indexed: 12/17/2022]
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Audiovestibular Symptoms in Systemic Autoimmune Diseases. J Immunol Res 2018; 2018:5798103. [PMID: 30211232 PMCID: PMC6120292 DOI: 10.1155/2018/5798103] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 06/11/2018] [Accepted: 07/04/2018] [Indexed: 12/16/2022] Open
Abstract
Immune-mediated inner ear disease can be primary, when the autoimmune response is against the inner ear, or secondary. The latter is characterized by the involvement of the ear in the presence of systemic autoimmune conditions. Sensorineural hearing loss is the most common audiovestibular symptom associated with systemic autoimmune diseases, although conductive hearing impairment may also be present. Hearing loss may present in a sudden, slowly, rapidly progressive or fluctuating form, and is mostly bilateral and asymmetric. Hearing loss shows a good response to corticosteroid therapy that may lead to near-complete hearing restoration. Vestibular symptoms, tinnitus, and aural fullness can be found in patients with systemic autoimmune diseases; they often mimic primary inner ear disorders such as Menière's disease and mainly affect both ears simultaneously. Awareness of inner ear involvement in systemic autoimmune diseases is essential for the good response shown to appropriate treatment. However, it is often misdiagnosed due to variable clinical presentation, limited knowledge, sparse evidence, and lack of specific diagnostic tests. The aim of this review is to analyse available evidence, often only reported in the form of case reports due to the rarity of some of these conditions, of the different clinical presentations of audiological and vestibular symptoms in systemic autoimmune diseases.
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Huang CM, Chen HJ, Huang PH, Tsay GJ, Lan JL, Sung FC. Retrospective cohort study on risk of hearing loss in patients with rheumatoid arthritis using claims data. BMJ Open 2018; 8:e018134. [PMID: 29306884 PMCID: PMC5780710 DOI: 10.1136/bmjopen-2017-018134] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Population studies on hearing loss (HL) associated with rheumatoid arthritis (RA) are lacking. This study investigated the risk of developing HL in patients with RA using a nationwide population cohort. SETTING The population-based insurance claims data in the Taiwan National Health Insurance Research Database. DESIGN Retrospective cohort study followed up RA cohort and control cohort without RA frequency matched by sex, age and diagnosis year. STUDY POPULATION 18 267 patients with RA newly diagnosed in 2000-2006 and 73 068 controls without RA. MAIN OUTCOMES Incidences of HL by the end of 2011 and the RA cohort to non-RA cohort HRs after adjusting for sex, age and comorbidities. RESULTS The HL incidence was higher in the RA cohort than in the non-RA cohort (3.08 vs 1.62 per 1000 person-years), with an adjusted HR (aHR) of 1.91 (95% CI 1.70 to 2.14) for the RA cohort relative to the non-RA cohort after controlling for age, sex and comorbidities. Men and the elderly are at a higher risk. Cardiovascular comorbidities were associated with a further increased HL risk for patients with RA. Medications were associated with reduced HL incidence; patients with RA who used non-steroidal anti-inflammatory drugs (NSAIDs) had an aHR of 0.12 (95% CI 0.07 to 0.20), compared with non-users. CONCLUSIONS This study demonstrates that patients with RA are at an increased risk of developing HL. Findings highlight the need of disease-modifying treatment and scheduled auditory examinations for HL prevention and early detection for patients with RA.
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Affiliation(s)
- Chung-Ming Huang
- Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hsuan-Ju Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- No department. Belong to College of Medicine., College of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Po-Hao Huang
- Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Gregory J Tsay
- Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Joung-Liang Lan
- Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Health Services Administration, China Medical University Hospital, Taichung, Taiwan
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Cochlear Histopathologic Findings in Patients With Systemic Lupus Erythematosus: A Human Temporal Bone Study. Otol Neurotol 2017; 37:593-7. [PMID: 27050650 DOI: 10.1097/mao.0000000000001017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
HYPOTHESIS We hypothesized that, in archived human temporal bone samples from patients with systemic lupus erythematosus (SLE), a pathologic condition exists in the stria vascularis and cochlear hair cells. BACKGROUND Sensorineural hearing loss is a common feature in SLE patients. However, the pathophysiologic mechanism of cochlear dysfunction is unclear. METHODS We examined 15 temporal bone samples from 8 SLE patients, along with 17 samples from 10 age-matched healthy control patients. The samples were serially sectioned in the horizontal plane and stained with hematoxylin and eosin. We determined the area of the stria vascularis in a midmodiolar section of each cochlear turn. Then, we made cytocochleograms and calculated the percentage of missing inner and outer hair cells. RESULTS The area of the stria vascularis in our SLE group was significantly smaller than in our control group. The number of remaining inner hair cells in our SLE group was smaller than in our control group; however, the difference did not reach statistical significance. The loss of outer hair cells in our SLE group was significantly higher than in our control group. There was a tendency toward a positive correlation between the loss of cochlear hair cells and the duration of SLE. CONCLUSION The stria vascularis and cochlear hair cells are affected in SLE patients. Our findings could provide the histopathologic basis for the cochlear dysfunction, including sensorineural hearing loss, experienced by SLE patients.
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Rahne T, Clauß F, Plontke SK, Keyßer G. Prevalence of hearing impairment in patients with rheumatoid arthritis, granulomatosis with polyangiitis (GPA, Wegener’s granulomatosis), or systemic lupus erythematosus. Clin Rheumatol 2017; 36:1501-1510. [DOI: 10.1007/s10067-017-3651-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 04/12/2017] [Accepted: 04/18/2017] [Indexed: 11/30/2022]
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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; 45:1470-1480. [PMID: 28345423 PMCID: PMC5718712 DOI: 10.1177/0300060516688600] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This literature review and meta-analysis was performed to evaluate the correlations among hearing and vestibular clinical symptoms, temporal bone findings, and pathological mechanisms in patients with systemic lupus erythematosus (SLE). Study design Relevant papers in the literature were retrospectively reviewed. Clinical hearing aspects in patients with SLE and relevant temporal bone studies in the same field were analyzed. Methods PubMed and Google Scholar searches were performed using the following keywords: “auto-immune disease,” “systemic lupus erythematosus (SLE),” “hearing loss,” “temporal bone study,” “vertigo,” “dizziness,” “tinnitus,” “ear symptoms,” “treatment,” “diagnosis,” “symptoms,” “etiopathogenesis,” “Wegener granulomatosis,” “Sjogren,” “polyarteritis nodosa,” “Cogan syndrome,” and “granulomatosis.” Also included were reviews in which the following terms were present: “SLE,” “temporal bone,” and “hearing symptoms.” Review and conclusion This literature review and meta-analysis focused on the pathological mechanisms through which SLE can damage inner ear structures and determinate hearing and vestibular symptoms. The main mechanisms involved in inner ear damage include the autoimmune response, deposition of immune complexes in the vessels and, to a lesser extent, cytotoxic damage.
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Affiliation(s)
- A Di Stadio
- 1 Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Massimo Ralli
- 2 Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy
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Chawki S, Aouizerate J, Trad S, Prinseau J, Hanslik T. Bilateral sudden sensorineural hearing loss as a presenting feature of systemic lupus erythematosus: Case report and brief review of other published cases. Medicine (Baltimore) 2016; 95:e4345. [PMID: 27603334 PMCID: PMC5023856 DOI: 10.1097/md.0000000000004345] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Sudden sensorineural hearing loss is an unusual presenting clinical feature of systemic lupus erythematosus. CASE REPORT We report the case of a young woman who was admitted to hospital for sudden sensorineural hearing loss and hemophagocytic syndrome which was attributed to systemic lupus erythematosus on the basis of specific renal involvement, thrombocytopenia, and consistent autoantibodies. Favorable outcome was obtained on high-dose corticosteroids, and the hearing fully recovered. DISCUSSION Sudden sensorineural hearing loss in systemic lupus erythematosus is seemingly more frequently associated with severe systemic involvement and antiphospholipid antibodies may be present. Although management remains empirical, the high risk of permanent hearing impairment seems to justify emergency treatment with high-dose corticosteroids. When the clinical and laboratory criteria of antiphospholipid syndrome are met, antiplatelets agents or anticoagulation therapy shall be considered.
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Affiliation(s)
- Sylvain Chawki
- Service de Médecine Interne, Hôpital Ambroise Paré, Assistance Publique Hôpitaux de Paris, APHP, Boulogne Billancourt
- Université de Versailles Saint Quentin en Yvelines, UVSQ, Versailles
- Correspondence: Sylvain Chawki, 20 avenue Corot, Le Vesinet 78110, France (e-mail: )
| | - Jessie Aouizerate
- Service de Néphrologie, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris, APHP, Créteil
| | - Selim Trad
- Service de Médecine Interne, Hôpital Ambroise Paré, Assistance Publique Hôpitaux de Paris, APHP, Boulogne Billancourt
- Université de Versailles Saint Quentin en Yvelines, UVSQ, Versailles
| | - Jacques Prinseau
- Service de Médecine Interne, Hôpital Ambroise Paré, Assistance Publique Hôpitaux de Paris, APHP, Boulogne Billancourt
- Université de Versailles Saint Quentin en Yvelines, UVSQ, Versailles
| | - Thomas Hanslik
- Service de Médecine Interne, Hôpital Ambroise Paré, Assistance Publique Hôpitaux de Paris, APHP, Boulogne Billancourt
- Université de Versailles Saint Quentin en Yvelines, UVSQ, Versailles
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136
- INSERM, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
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Low-Density Lipoprotein Cholesterol Is Associated With Asymptomatic Sensorineural Hearing Loss in Patients With Systemic Lupus Erythematosus. J Clin Rheumatol 2016; 22:312-5. [DOI: 10.1097/rhu.0000000000000382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rossini BAA, Penido NDO, Munhoz MSL, Bogaz EA, Curi RS. Sudden Sensorioneural Hearing Loss and Autoimmune Systemic Diseases. Int Arch Otorhinolaryngol 2016; 21:213-223. [PMID: 28680488 PMCID: PMC5495599 DOI: 10.1055/s-0036-1586162] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 06/03/2016] [Indexed: 10/25/2022] Open
Abstract
Introduction Several authors have demonstrated the relationship between sudden sensorineural hearing loss (SNHL) and systemic autoimmune diseases (SAD). Immune-mediated SNHL can rarely present as unilateral sudden SNHL and manifests itself in the contralateral ear only after years. It presents clinical relevance for being one of the few SNHL that may be reversible given that early and appropriate treatment is applied. Objective The objective of this study is to describe the clinical presentations and audiological findings from patients with idiopathic sudden SNHL and SAD associated with a probable diagnosis of immune-mediated SNHL. Furthermore, we strive to estimate the prevalence of SAD in patients with sudden SNHL. Methods This is an observational retrospective cohort. We have selected and studied patients with SAD. Revision of available literature on scientific repositories. Results We evaluated 339 patients with sudden SNHL. Among them, 13 (3.83%) patients suffered from SAD. Three patients had bilateral involvement, a total of 16 ears. We evaluate and describe various clinical, epidemiological, and audiological aspects of this sample. Conclusion In our sample of patients with sudden SNHL, the prevalence of SAD was found relevant. The majority had tinnitus and dizziness concomitant hearing loss, unilateral involvement and had experienced profound hearing loss at the time of the installation. In spite of instituted treatment, most cases showed no improvement in audiometric thresholds. Apparently, patients with sudden SNHL and SAD have a more severe initial impairment, higher percentage of bilateral, lower response to treatment, and worse prognosis than patients with sudden SNHL of unknown etiology.
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Affiliation(s)
| | | | | | | | - Renata Souza Curi
- Department of ENT, Universidade Federal de São Paulo, São Paulo, Brazil
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Abstract
BACKGROUND AND AIMS Inflammatory bowel disease (IBD) has many characteristics of autoimmune diseases. Sensorineural hearing loss has been reported in many autoimmune diseases. Little is known about hearing loss in patients with IBD. METHODS A prospective blinded comparative study was conducted over a 3-year period. IBD patients and controls underwent a complete otorhinolaryngeal examination and eudiometry test. RESULTS Altogether 105 participants (76 patients and 29 controls) took part in this study. Mean age was 36, 51 % were males, and 40 % of the patients were presently hospitalized due to IBD exacerbation. Audiometric examination revealed that any hearing loss (mild to severe) was found in 29 (38 %) of the IBD population, compared to 4 (14 %) of the control group (p = 0.02). Extraintestinal manifestation (EIM) was present in 33/76 (43 %) of IBD patients. Any hearing loss and moderate to severe hearing loss were found in 17/33 (52 %) and 7/33 (21 %) in the EIM-positive group compared to 12/43 (28 %) and 4/43 (9 %) in the EIM-negative group (p = 0.036 and p = 0.14, respectively). Out of patients over the age of 40 with other EIMs, all 11/11 (100 %) of patients had any hearing loss compared to 8/12 (66 %) of patients over the age of 40 without other EIMs, p = 0.035. CONCLUSIONS Hearing loss may be another EIM of IBD. It is found in 38 % of IBD patients and in up to 52 % of patients with other EIMs and increases over the age of 40. Early hearing evaluation should be recommended to these high-risk IBD patients.
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Recurrence of idiopathic sudden sensorineural hearing loss: a retrospective cohort study. Otol Neurotol 2015; 35:1736-41. [PMID: 25303958 DOI: 10.1097/mao.0000000000000630] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To explore the recurrence rate of idiopathic sudden sensorineural hearing loss (ISSNHL). DESIGN Using the Taiwan Longitudinal Health Insurance Database, we compared in a retrospective cohort study 45,715 patients with ISSNHL between January 2001 and December 2006 with 45,715 age-, gender-, and comorbidity-matched controls without ISSNHL. We followed each patient from 180 days after the initial diagnosis until the end of 2009 and evaluated the incidence of ISSNHL for 3 years minimum. RESULTS The cumulative incidence of ISSNHL recurrence was 4.99%. Cox proportional hazard regressions showed that the 50- to 64-year-old age group had a higher adjusted hazard ratio (1.59; 95% confidence interval: 1.40-1.81) than did the 0- to 34-year-old age group. Different comorbidities did not significantly affect the incidence of ISSNHL relapse. CONCLUSIONS The risk of an ISSNHL relapse in patients with a history of ISSNHL was higher than was the risk of a first occurrence of ISSNHL in the Controls. We suggest that physicians counsel patients with a history of ISSNHL to seek medical attention if they have hearing impairments because they may also have a high risk of an ISSNHL relapse. EVIDENCE LEVEL 2B.
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Yen YC, Lin YS, Weng SF, Lai FJ. Risk of sudden sensorineural hearing loss in patients with psoriasis: a retrospective cohort study. Am J Clin Dermatol 2015; 16:213-20. [PMID: 25687690 DOI: 10.1007/s40257-015-0117-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
SIGNIFICANCE Psoriasis, a common immune-mediated disease, affects approximately 2% of the population worldwide. Sudden sensorineural hearing loss (SSNHL) might be a manifestation of systemic vascular involvement in autoimmune disease. However, to the best of our knowledge, there is no systematic English-language examination of the risk of SSNHL in patients with psoriasis. OBJECTIVES We tested the hypothesis that psoriasis is a risk factor for developing SSNHL. METHODS Using Taiwan's National Health Insurance Research Database, we conducted a retrospective cohort study to compare patients diagnosed with psoriasis from January 1, 2001 through December 31, 2006 (n=28,817) with gender-, age-, and comorbidities-matched controls (n=28,817). We followed each patient until the end of 2011 and evaluated the incidence of SSNHL for at least 6 years after the initial psoriasis diagnosis. RESULTS The incidence of SSNHL was 1.51 times higher in the psoriasis cohort than in the control cohort (7.12 vs 4.73 per 10,000 person-years). Using Cox proportional hazard regressions, the adjusted hazard ratio (AHR) was 1.51 (95% confidence interval [CI] 1.18-1.93). Comorbid hypertension was an independent risk factor for SSNHL (AHR 1.49; 95% CI 1.05-2.13). However, the incidence rate ratios (IRRs) for each comorbidity subgroup in the psoriasis and control cohorts were not significantly different. CONCLUSIONS AND RELEVANCE Psoriasis was significantly associated with a higher risk of developing SSNHL. We suggest that physicians advise patients with psoriasis to seek medical attention if they have hearing impairments, because they may also have a higher risk of developing SSNHL.
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Ramos-Casals M, Brito-Zerón P, Kostov B, Sisó-Almirall A, Bosch X, Buss D, Trilla A, Stone JH, Khamashta MA, Shoenfeld Y. Google-driven search for big data in autoimmune geoepidemiology: analysis of 394,827 patients with systemic autoimmune diseases. Autoimmun Rev 2015; 14:670-9. [PMID: 25842074 DOI: 10.1016/j.autrev.2015.03.008] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 03/30/2015] [Indexed: 01/08/2023]
Abstract
Systemic autoimmune diseases (SADs) are a significant cause of morbidity and mortality worldwide, although their epidemiological profile varies significantly country by country. We explored the potential of the Google search engine to collect and merge large series (>1000 patients) of SADs reported in the Pubmed library, with the aim of obtaining a high-definition geoepidemiological picture of each disease. We collected data from 394,827 patients with SADs. Analysis showed a predominance of medical vs. administrative databases (74% vs. 26%), public health system vs. health insurance resources (88% vs. 12%) and patient-based vs. population-based designs (82% vs. 18%). The most unbalanced gender ratio was found in primary Sjögren syndrome (pSS), with nearly 10 females affected per 1 male, followed by systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and antiphospholipid syndrome (APS) (ratio of nearly 5:1). Each disease predominantly affects a specific age group: children (Kawasaki disease, primary immunodeficiencies and Schonlein-Henoch disease), young people (SLE Behçet disease and sarcoidosis), middle-aged people (SSc, vasculitis and pSS) and the elderly (amyloidosis, polymyalgia rheumatica, and giant cell arteritis). We found significant differences in the geographical distribution of studies for each disease, and a higher frequency of the three SADs with available data (SLE, inflammatory myopathies and Kawasaki disease) in African-American patients. Using a "big data" approach enabled hitherto unseen connections in SADs to emerge.
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Affiliation(s)
- Manuel Ramos-Casals
- Josep Font Laboratory of Autoimmune Diseases, CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain.
| | - Pilar Brito-Zerón
- Josep Font Laboratory of Autoimmune Diseases, CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain
| | - Belchin Kostov
- Primary Care Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Primary Care Centre Les Corts, CAPSE, Barcelona, Spain
| | - Antoni Sisó-Almirall
- Primary Care Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Primary Care Centre Les Corts, CAPSE, Barcelona, Spain
| | - Xavier Bosch
- Department of Internal Medicine, ICMiD, Hospital Clínic, Barcelona, Spain
| | - David Buss
- Josep Font Laboratory of Autoimmune Diseases, CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain
| | - Antoni Trilla
- Preventive Medicine and Epidemiology Unit, Hospital Clínic-Universitat de Barcelona, Barcelona Centre for International Health Research, Barcelona, Catalonia, Spain
| | - John H Stone
- Harvard Medical School, Boston, MA 02114, USA; Department of Medicine, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Munther A Khamashta
- Lupus Research Unit, The Rayne Institute, St Thomas' Hospital, King's College University, London, UK
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel Hashomer, Israel Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Koo M, Hwang JH. Risk of sudden sensorineural hearing loss in patients with common preexisting sensorineural hearing impairment: a population-based study in Taiwan. PLoS One 2015; 10:e0121190. [PMID: 25815507 PMCID: PMC4376683 DOI: 10.1371/journal.pone.0121190] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 01/28/2015] [Indexed: 12/02/2022] Open
Abstract
Objective The role of preexisting sensorineural hearing impairment on the risk for sudden sensorineural hearing loss (SSHL) is still unclear. In this study, we aimed to assess the risk of SSHL in patients with common preexisting sensorineural hearing impairment using population-based data. Methods A population-based case-control study design was used to analyze claims data between January 2001 and December 2011 obtained from the Taiwan National Health Insurance Research Database. The cases consisted of 514 patients with SSHL and the controls were frequency matched to 2,570 cases by sex, 10-year age group, and year of index date. Common sensorineural hearing impairments were retrospectively assessed in the cases and controls. Associations between sensorineural hearing impairment and risk of SSHL were evaluated using unconditional univariate and multivariate logistic regression analyses. Results The mean age for the 3,084 study subjects was 53.1 years (standard deviation, S.D. = 15.6). Of the 514 cases, 49 (9.5%) had sensorineural hearing impairment while only 44 (1.7%) of the 2,570 controls had the same condition. Univariate logistic regression analyses indicated that preexisting sensorineural hearing impairment was significantly associated with SSHL (odds ratio, OR = 6.05, p < 0.001). Other comorbidities including hypertension, diabetes mellitus, and hyperlipidemia also showed significant associations with SSHL. Similar results were obtained when the association between SSHL and sensorineural hearing impairment was adjusted with either all the covariates (adjusted OR = 6.22, p < 0.001) or with only those selected using a backward elimination procedure (adjusted OR = 6.20, p < 0.001). Conclusions Results from this population-based case-control study revealed that common sensorineural hearing impairment might be a novel risk factor for SSHL.
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Affiliation(s)
- Malcolm Koo
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Juen-Haur Hwang
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
- Sleep Center, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
- * E-mail:
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Progressive, reversible sensorineural hearing loss caused by azathioprine. The Journal of Laryngology & Otology 2014; 128:838-40. [DOI: 10.1017/s0022215114001807] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:This paper describes the first reported case of progressive sensorineural hearing loss caused by azathioprine, which was reversed on stoppage of the drug.Case report:A female patient with previously normal hearing presented with progressive sensorineural hearing loss after being started on azathioprine. Otological and neurological examination findings were unremarkable. After stopping the drug, the patient reported an improvement in hearing, which was confirmed on pure tone audiometry.Conclusion:This previously unreported side effect of azathioprine is highlighted in order to increase clinical awareness. Early recognition of this adverse effect is important to minimise the possibility of permanent sensorineural hearing loss.
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Masuda M, Kanzaki J. Cause of idiopathic sudden sensorineural hearing loss: The stress response theory. World J Otorhinolaryngol 2013; 3:42-57. [DOI: 10.5319/wjo.v3.i3.42] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Revised: 06/14/2013] [Accepted: 07/25/2013] [Indexed: 02/06/2023] Open
Abstract
The stress response theory is a relatively new concept about the cause of idiopathic sudden sensorineural hearing loss (ISHL). A number of possible etiologies have been proposed in the literature, as discussed in this paper, but each proposed etiology has been both supported and refuted in the literature. However, the stress response theory can integrate hypotheses that have been advocated so far. The word “stress” refers to a constellation of physical and psychological stimuli including systemic viral and bacterial illness, systemic inflammatory disorders, and physical, mental or metabolic stress. Numerous studies have demonstrated adverse effects of systemic stress on health. Stress causes changes in the immune system and cytokine network through activation of the hypothalamus-pituitary-adrenal axis and the sympathetic nervous system. Several types of catecholamine and cytokine receptors are in the cochlea cells other than capillary cells, and then they can respond to systemic stressors. However, there are few studies examining how systemic stress is associated with cochlear dysfunction. The stress response theory addresses this question. In the theory, a variety of stressors and risk factors contribute to the onset of ISHL in varying degrees. The lateral wall of the cochlea has very unique responses to systemic stressors. It plays a critical role in causing ISHL. Systemic stressors converge at the lateral wall and trigger pathological activation of nuclear factor κ-light-chain-enhancer of activated B cells, a transcriptional factor known as a stress sensor. This activation enhances local expression of genes associated with immune and inflammatory system, resulting in cochlear dysfunction. We review the original stress response theory advocated by Adams et al and the integrative stress response theory that integrates our knowledge about the etiologies of ISHL so far.
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