Background Patients with systemic rheumatic diseases have increased prevalence of sensorineural hearing loss (SNHL). Detection of cochlin specific antibodies has been reported in patients with idiopatic sensorineural hearing loss. Interestingly, cochlin has been shown a stronger link to autoimmune hearing loss.
Objectives Objective of this cross-sectional study was to calculate the prevalence of SNHL in patients with systemic rheumatic diseases and to detect human cochlin antibodies in their sera.
Methods This was a prospective study. Patients older that 18 year old who gave informed consent and fulfilled the criteria of American College of Rheumatology for rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjogren's syndrome (SS) and systemic sclerosis (SSc) were included. Complete head and neck clinical examination was performed, including otoscopy, nasendoscopy and hearing investigation with pure tone audiometry (250Hz -8000Hz). All medical treatments as well as Disease activity score (DAS) 28 for RA and SLE disease activity index (SLEDAI) for SLE were documented. An average tone loss was calculated, taking as a starting point the loss in dB at various frequencies according the American Committee on Hearing and Equilibrium Guidelines for Meniere's disease and also recommendation 02/1 of “Bureau International d' Audiophonologie” (BIAP). Blood samples of the patients were tested for the presence of IgG anti-cochline antibodies (COCH-IgG). The results were compared with those of sex and age-matched healthy subjects.
Results We studied 133 patients (60 with RA, 41 with SLE, 24 with SS and 8 with SSc) and 133 healthy subjects.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 SNL was increased in patients affected by RA, SLE, SS and SSc in comparison to healthy controls (66.6%, 31.71%, 54.17% and 75% respectively). The average hearing thresholds (AHT) calculated using BIAP recommendation 02/1 were significantly increased in RA compared to SLE. AHT were also increased in patients with RA and secondary SS but without statistical significance compared to RA patients. There was a statistically significant correlation between AHT and DAS28 in RA. No correlation observed between AHT and SLEDAI. COCH-IgG were detected in two samples (one patient with RA and one with RA and SS).
Conclusions Cochlin has been shown to have a stronger link to autoimmune hearing loss, but our study concluded no correlation of hearing loss with human cochlin IgG (COCH). Additional prospective studies are needed to elucidate its pathogenesis.
Disclosure of Interest None declared
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