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Association of systemic lupus erythematosus with hearing loss: a systemic review and meta-analysis

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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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Acknowledgements

We do not have any financial relationship to this article.

Funding

We did not receive any funding to conduct this study.

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Author notes

  1. Vasileios Paraschou and Nikolaos Chaitidis authors contributed equally.

Authors and Affiliations

  1. Hellenic Police Medical Center, Thessaloniki, Greece

    Vasileios Paraschou & Patroklos Theocharis

  2. Hellenic Army Medical Corps, Kastoria, Greece

    Nikolaos Chaitidis

  3. 3rd Department of Pediatrics, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Zoi Papadopoulou

  4. 1st Department of Pediatrics, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Pavlos Siolos

  5. Department of Otorhinolaryngology, 401 General Military Hospital of Athens, Athens, Greece

    Charalampos Festas

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  1. Vasileios Paraschou
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  4. Patroklos Theocharis
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Contributions

NC, VP and CF conceptualized and designed the study. ZP and PT searched the literature, screened the studies, selected the eligible studies and extracted the data. VP verified the accuracy of the selected studies and the extracted data. VP and PS assessed the quality of the included studies. NC and VP analyzed the data and carried out the statistical analyses. NC and VP wrote the manuscript, and all other authors reviewed it critically. All authors revised the final manuscript and approved it for publication submission. All authors agree to be accountable for all aspects of the work in ensuring that questions related to quality of the work are appropriately examined and resolved. All authors gave the final approval for the manuscript to be submitted in journal.

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Correspondence to Nikolaos Chaitidis.

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Paraschou, V., Chaitidis, N., Papadopoulou, Z. et al. Association of systemic lupus erythematosus with hearing loss: a systemic review and meta-analysis. Rheumatol Int 41, 681–689 (2021). https://doi.org/10.1007/s00296-021-04788-5

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