Sudden deafness in a patient with temporal arteritis

Area of Science:

• Internal Medicine
• Rheumatology
• Ophthalmology

Background:

• Temporal arteritis (giant cell arteritis) is a systemic vasculitis primarily affecting medium and large arteries.
• It commonly presents with headache, jaw claudication, and visual disturbances, but can have varied manifestations.
• Anemia and elevated erythrocyte sedimentation rate are common laboratory findings in active disease.

Observation:

• A patient with anemia and elevated erythrocyte sedimentation rate experienced sudden, unilateral hearing loss.
• The clinical presentation prompted investigation for underlying inflammatory conditions.
• Temporal artery biopsy confirmed the diagnosis of temporal arteritis.

Findings:

• Corticosteroid therapy was initiated promptly upon diagnosis.
• The patient showed a rapid and significant improvement in hearing.
• Other systemic manifestations of temporal arteritis also resolved with treatment.

Implications:

• Sudden hearing loss should be considered a potential presenting symptom of temporal arteritis.
• Early diagnosis and aggressive corticosteroid treatment are crucial for preventing irreversible complications, including vision loss.
• This case highlights the importance of a high index of suspicion for temporal arteritis in patients with unexplained hearing loss and systemic inflammatory markers.