Subclinical sensorineural hearing loss in systemic lupus erythematosus: a comparative cross-sectional study.

Introduction: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that damages multiple target organs, including the ear. This study aims to determine the prevalence of hearing loss in patients with a confirmed diagnosis of SLE compared to controls and to assess frequency-specific hearing thresholds using extended audiometry (500 to 16,000 Hz).

Methods: This comparative cross-sectional study included 75 patients diagnosed with SLE and 150 matched control subjects. All subjects underwent otolaryngological evaluation, conventional and extended audiometry (500 to 8,000 and 10,000 to 16,000 Hz, respectively), and tympanometry.

Results: Patients with SLE showed a higher prevalence of sensorineural hearing loss (SNHL) at all frequencies and elevated thresholds at very high frequencies compared to the controls (p < 0.05). The most affected rage was 10-16 kHz, with an average threshold of 24.7 dB (IQR 13.1 - 44.4) and a SNHL prevalence of 50.7% in patients with SLE vs. 9.3% and 18.7% in both control groups (p < 0.001). Multivariate analysis showed that being a patient with SLE (OR = 10.84; p < 0.001) and older age (OR = 1.13/year; p < 0.001) were independent predictors of SNHL. In the SLE subgroup, age remained the only significant predictor (OR = 1.16; p < 0.001).

Conclusion: Patients with SLE have higher odds of developing SNHL compared to healthy controls and demonstrate a significantly increased prevalence of SNHL, particularly at very-high frequencies, which can only be detected through extended audiometry. These findings underscore the utility of extended audiometry in early detection of subclinical SNHL. Key Points • Patients with SLE shows a higher prevalence of SNHL, especially in very-high frequencies. • Patients with SLE demonstrated increased hearing thresholds when compared to control groups, particularly in very-high frequencies. • No significance was identified when compared chloroquine use and SNHL prevalence. • SLE and age were significant predictors of SNHL, whereas comorbidities, disease activity, and treatment were not.