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Cochlear involvement in patients with systemic autoimmune rheumatic diseases: a clinical and laboratory comparative study

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Inner ear involvement has been reported in systemic rheumatic disease while detection of cochlin-specific antibodies has been reported in patients with idiopatic sensorineural hearing loss, suggesting cochlin’s strong link to autoimmune hearing loss. The aim of this cross-sectional study was to calculate the prevalence of sensorineural hearing loss (SNHL) in patients with systemic rheumatic diseases, and to investigate any potential correlation with human antibodies to cochlin.

Methods

Patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjogren’s syndrome (SS) and systemic sclerosis (SSc) according to the criteria of American College of Rheumatology were included in the study. All patients underwent a complete ear-nose-throat physical examination and audiological evaluation with pure tone audiometry and impedance audiometry. Pure tone average was calculated, taking as a starting point the hearing loss in dB according to the recommendation 02/1 of “Bureau International d' Audiophonologie” (BIAP) so as an average hearing threshold value. Sera of all patients were tested for the presence of IgG antibodies to human cochline (COCH-IgG). Sex and age-matched healthy subjects were included as controls to each group.

Results

A total of 133 patients were studied; 60 with RA, 41 with SLE, 24 with SS and 8 with SSc. 61.4% of patients reported vertigo, 41% hyperacousis, 39% hearing loss, 38% tinnitus, 37.9% headache and 2.1% sensation of ear pressure with unremarkable otoscopy. The prevalence of SNHL calculated for patients affected by RA, SLE, SS and SSc was 66.6%, 31.71%, 54.17%, and 75% respectively. The calculated average hearing thresholds value in RA was increased in comparison to SLE (p < 0.05). In addition it was also higher in patients with RA and secondary SS, in comparison to RA patients (p > 0.05). There was statistically significant correlation of average hearing threshold with disease activity score 28 (DAS28) in RA, but no correlation observed with disease activity index (SLEDAI) in SLE. COCH-IgG antibodies were detected in only two samples. The results were compared with those of their respective sex and age-matched healthy subjects.

Conclusion

Our study revealed increased prevalence of SNHL in patients with systemic autoimmune rheumatic disease but no correlation of hearing loss with COCHIgG antibodies. The mechanism of inner ear damage remains unknown; thus, additional prospective studies will be needed to elucidate its pathogenesis.

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Funding

This study was funded by the University of Ioannina.

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Authors and Affiliations

  1. Department of Otolaryngology, University Hospital of Ioannina, Leof. Stavrou Niarchou, 45500, Ioannina, Greece

    Georgios K. Tsirves

  2. Department of Rheumatology, University Hospital of Ioannina, Ioannina, Greece

    Paraskevi V. Voulgari, Eleftherios Pelechas & Alexandros A. Drosos

  3. Department of Otolaryngology, Hospital Center of Luxembourg, Luxembourg, Luxembourg

    Asimakis D. Asimakopoulos

Authors
  1. Georgios K. Tsirves
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  2. Paraskevi V. Voulgari
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  3. Eleftherios Pelechas
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  4. Asimakis D. Asimakopoulos
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  5. Alexandros A. Drosos
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Corresponding author

Correspondence to Georgios K. Tsirves.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Tsirves, G.K., Voulgari, P.V., Pelechas, E. et al. Cochlear involvement in patients with systemic autoimmune rheumatic diseases: a clinical and laboratory comparative study. Eur Arch Otorhinolaryngol 276, 2419–2426 (2019). https://doi.org/10.1007/s00405-019-05487-5

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  • DOI: https://doi.org/10.1007/s00405-019-05487-5

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