[Autoimmune hearing loss in giant cell arteritis: a clinical case]
I V Savenko1, M Yu Boboshko1, S V Bryzgalova1
1Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia.
Vestnik Otorinolaringologii
|March 1, 2026
Summary
Giant cell arteritis (GCA), or temporal arteritis, can cause hearing loss. This case study shows GCA presenting atypically after SARS-CoV-2 infection, leading to hearing impairment that improved with corticosteroid therapy.
Area of Science:
- Rheumatology
- Otolaryngology
- Infectious Disease
Background:
- Giant cell arteritis (GCA), a systemic vasculitis primarily affecting large vessels in individuals over 50, can present with varied symptoms.
- Cochleovestibular dysfunction, including sensorineural hearing loss, is an uncommon but recognized manifestation of GCA, potentially preceding other symptoms.
- The interplay between autoinflammatory and autoimmune processes contributes to arterial damage and potential ischemia in GCA.
Purpose of the Study:
- To present a clinical case of atypical Giant cell arteritis (GCA) manifesting after SARS-CoV-2 infection.
- To highlight the diagnostic challenges posed by GCA mimicking other conditions like granulomatosis with polyangiitis.
- To emphasize the importance of timely diagnosis and corticosteroid treatment for hearing improvement in GCA-related cochleovestibular dysfunction.
Main Methods:
- Case report detailing an atypical presentation of GCA following SARS-CoV-2 infection.
- Clinical evaluation including assessment of rhinosinusitis, otitis media with effusion, and profound mixed hearing loss.
- Diagnostic exclusion of other autoimmune conditions based on antibody levels and clinical features.
- Therapeutic intervention with urgent corticosteroid administration.
Main Results:
- The patient developed subacute rhinosinusitis and bilateral otitis media with effusion post-SARS-CoV-2 infection, leading to profound mixed hearing loss.
- Clinical presentation mimicked granulomatosis with polyangiitis, but serological markers were negative.
- Unilateral vision loss occurred 12 months after disease onset, aiding in GCA verification.
- Prompt corticosteroid therapy resolved main symptoms and significantly improved hearing.
Conclusions:
- This case illustrates an unusual GCA presentation post-SARS-CoV-2, involving middle and inner ear pathologies.
- The findings suggest a potential link between SARS-CoV-2 infection, GCA pathogenesis, and cochleovestibular dysfunction.
- Early recognition and treatment of GCA are crucial for preventing irreversible complications like hearing loss and vision loss.
