Sensorineural hearing loss in lupus erythematosus

Area of Science:

• Rheumatology
• Otolaryngology
• Immunology

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
• Sensorineural hearing loss (SNHL) is a recognized but uncommon complication of SLE.
• The association between SLE and SNHL requires further investigation regarding underlying mechanisms and clinical impact.

Observation:

• A 51-year-old woman presented with acute, profound SNHL in the right ear, followed by similar hearing loss in the left ear three weeks later.
• Diagnostic work-up confirmed SLE based on high antinuclear antibody titers and specific immunofluorescence findings on biopsy.
• The patient's hearing loss remained unresponsive to immunosuppressive therapy with prednisone and cyclophosphamide.

Findings:

• This case represents the second documented instance of SLE associated with SNHL.
• Crucially, this is the first reported case of bilateral SNHL occurring in the context of SLE.
• The profound and bilateral nature of SNHL in this patient underscores a potentially severe otologic manifestation of SLE.

Implications:

• This case expands the known spectrum of otologic complications in SLE.
• It suggests that SLE should be considered in the differential diagnosis of patients presenting with unexplained bilateral SNHL.
• Further research is warranted to elucidate the pathophysiology of SLE-induced SNHL and to develop targeted therapeutic strategies.