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Exploration of risk factors affecting hearing loss in patients with granulomatosis with polyangiitis: A single-center
Chen Li1, Zhijin Han1, Mengyao Xie1
1Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Introduction:
Granulomatosis with polyangiitis (GPA) commonly affects the ears, leading to irreversible hearing loss and impacting patients' quality of life. This study aims to explore and summarize the risk factors associated with hearing loss in GPA patients, providing value for early diagnosis and improved prognosis.
Materials And Methods:
We collected information from patients during their hospitalization at this center from 2013 to 2023, including 19 patients with normal hearing and 89 patients with hearing impairment which is divided into four groups furtherly. Information on basic characteristics, laboratory tests, clinical manifestations, and treatment methods was collected. Initial univariate analysis was conducted for variable selection, followed by multivariate analysis to further verify if the selected factors are risk factors causing hearing impairment and to explore further.
Results:
In different subgroups of hearing loss, it was found that age, levels of p-ANCA, ear involvement, eye involvement, and concurrent facial paralysis significantly exacerbate the level of hearing loss. Conversely, the levels of proteinase 3 anti-neutrophil cytoplasmic antibodies (PR3-ANCA), treatment with rituximab (RTX), and the level of hearing loss are negatively correlated. Through multifactor analysis, age, ear involvement, eye involvement, and facial palsy were identified as risk factors for more severe hearing loss. Furthermore, we analyzed the distribution of types of hearing loss in different severity groups and observed that the more severe the hearing loss, the higher the proportion of sensorineural hearing loss.
Conclusion:
This study found that age, ear involvement, eye involvement, and facial palsy are four factors that contribute to irreversible hearing loss in patients with granulomatosis with polyangiitis (GPA). The occurrence of hearing loss in GPA patients appears to progress from conductive hearing loss to sensorineural hearing loss, indicating some mechanisms behind the hearing loss in GPA patients.
