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Prevalence of hearing impairment in patients with rheumatoid arthritis, granulomatosis with polyangiitis (GPA, Wegener’s granulomatosis), or systemic lupus erythematosus

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Abstract

Hearing loss in patients with autoimmune diseases, such as systemic lupus erythematosus (SLE), granulomatosis with polyangiitis (GPA, Wegener’s granulomatosis), or rheumatoid arthritis (RA), is controversial. Many studies lack measurements of bone-conduction thresholds to sufficiently differentiate between sensorineural hearing loss and conductive hearing loss. In addition, many studies lack control groups or comparisons to an age-related normal hearing threshold. This study investigates hearing performance with an extended audiological battery using psychoacoustic and objective measures. A total of 22 adults with RA, 16 with GPA, 20 with SLE, and two age- and gender-matched control groups (n = 34 for GPA and RA and n = 42 for SLE) were included. Pure-tone hearing thresholds, speech perception in quiet and noise, tympanometry, and high-resolution otoacoustic emissions were assessed. GPA patients exhibited impaired pure-tone hearing compared to the control group, whereas SLE and RA patients did not. In GPA patients, a larger air-bone gap indicated conductive hearing loss. In addition, speech perception was reduced exclusively in GPA patients. A significant correlation was found between hearing loss and both the cumulative steroid dose and number of organ manifestations in GPA and SLE patients. Our data indicate that GPA and SLE patients are at moderate-to-high risk of conductive hearing loss. In contrast, RA patients are at low risk of disease-associated hearing loss.

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Acknowledgements

We thank Jan-Leif Sommermeyer (Halle/Saale) for patient recruitment and data recording. We thank Manfred Mauermann (Oldenburg) for providing the hardware for DPOAE and fine structure hearing threshold measurements.

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Author notes

  1. Torsten Rahne and Franziska Clauß contributed equally to the manuscript.

Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany

    Torsten Rahne, Franziska Clauß & Stefan K. Plontke

  2. Clinic for Internal Medicine II, Department of Internal Medicine, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle, Germany

    Franziska Clauß & Gernot Keyßer

Authors
  1. Torsten Rahne
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  2. Franziska Clauß
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  3. Stefan K. Plontke
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  4. Gernot Keyßer
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Corresponding author

Correspondence to Torsten Rahne.

Ethics declarations

All patients provided written informed consent. The study was approved by the local ethics committee.

Funding

This work was supported by intramural funding. No third party funding was provided.

Disclosures

None.

Additional information

Key messages

• We found neither conductive hearing loss nor mixed hearing loss in RA patients.

• We found a high conductive hearing loss and mixed hearing loss prevalence in the GPA group.

• The prevalence of sensorineural hearing loss was higher in SLE patients than in the control group.

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Rahne, T., Clauß, F., Plontke, S.K. et al. Prevalence of hearing impairment in patients with rheumatoid arthritis, granulomatosis with polyangiitis (GPA, Wegener’s granulomatosis), or systemic lupus erythematosus. Clin Rheumatol 36, 1501–1510 (2017). https://doi.org/10.1007/s10067-017-3651-4

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  • DOI: https://doi.org/10.1007/s10067-017-3651-4

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