Background Both sensorineural hearing impairment (SNHI) and conductuve hearing impairment (CHI) have been reported in about 50% of patients with rheumatoid arthritis (RA). Previous reports have related SNHI with advanced age, disease activity, rheumatoid nodules, erythrocyte sedimentation rate (ESR), serum IL-6 and serum matrix metalloproteases. These findings are suggestive that inflammatory activitiy in RA may be related with SNHI development. Notwhitstanding, scarce information about the impairment of tympano-ossicular complex compliance is reported.
Objectives The aim of this study is to evaluate hearing impairment (HI) in patients with RA and examined the association between clinical characteristics, disease activity and inflammatory markers in Mexican patients with RA.
Methods The study group was comprised of 41 patients with RA. Patients were examined using pure-tone audiometry and tympanometry. The Disease Activity Index 28 (DAS-28) by c reactive protein (cRP) was calculated. Data was analyzed using descriptive statistics, Student's T test, chi-square and ANOVA, accordingly with SPSS V.18 software.
Results We found 58.5% RA patients with SNHI. Of these, 9.7% had superficial, 9.7% mild and 2.4% profound SNHI. Patients with SNHI were older at diagnosis than patients without SNHI (44.5±8.7 vs 32.1±10.1, P <0.01). According to tympanometric curve patients were grouped with As tympanogram (n=17) and with A tympanogram (n=23). Sixty percent of As tympanogram RA patients had moderate/severe disease activity (DAS28 >5.1) vs. 17.6% of A tympanogram group (p<0.05). ESR, cRP and anti-CCP antibodies were significantly correlated with hearing thresholds of high and low frequencies. Patients with severe/moderate disease activity had lower tympanic compliance when compared to patients with mild disease activity or remission, 0.38±0.18 vs. 0.67±0.33 vs. 0.50±0.18, P =0.01.
Conclusions The type and degree most prevalent of HI in our study group was superficial SNHL and was found to be related with aging and older age at diagnosis. These findings suggest that ear involvement in RA, may exacerbate aging related HI Increasing disease activity. Levels of inflammatory markers and the presence of anti-CCP antibodies are related with worse HI in RA.
Disclosure of Interest None declared