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Hearing Loss in the Sjogren Syndrome

Bruno Tumiati, MD; Patrizia Casoli, MD; and Alfredo Parmeggiani, MD
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From Ospedale Santa Maria Nuova, Reggio Emilia, Italy. Acknowledgment: The authors thank Mrs. Antonella Berselli for technical assistance. Requests for Reprints: Bruno Tumiati, MD, 2nd Department of Internal Medicine, Ospedale S. Maria Nuova, Viale Risorgimento, 42100 Reggio Emilia, Italy. Current Author Addresses: Drs. Tumiati and Casoli: 2nd Department of Internal Medicine, Ospedale S. Maria Nuova, Viale Risorgimento, 42100 Reggio Emilia, Italy.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1997;126(6):450-453. doi:10.7326/0003-4819-126-6-199703150-00005
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Background: Ear involvement is not unusual in autoimmune diseases, but few data on this problem in the Sjogren syndrome are available.

Objectives: To determine whether the incidence of hearing loss is increased in patients with the Sjogren syndrome and to determine what factors might be involved in the pathogenesis of Sjogren syndrome-related hearing loss.

Design: Cross-sectional study.

Setting: Secondary referral center in ltaly.

Patients: 30 women with the Sjogren syndrome were evaluated for evidence of audiovestibular disorder. Their results were compared with those of 40 age-matched healthy women.

Measurements: Evaluation techniques included pure tone audiometry thresholds at octave frequencies of 125 Hz to 8000 Hz, tympanometry, and the stapedial reflex test in both ears. The presence of vasculitis, the Raynaud phenomenon, nervous system involvement, and serum anticardiolipin antibodies was recorded.

Results: 14 patients with the Sjogren syndrome (46% [95% CI, 28% to 66%]) had sensorineural hearing loss. Only one control (2.5% [CI, 0.06% to 13%]) had a similar hearing impairment (P < 0.001). Nine of the 14 patients who had the Sjogren syndrome and sensorineural hearing loss (64% [CI, 36% to 87%]) had anticardiolipin antibodies compared with only 3 controls (18% [CI, 4% to 45%]) (P = 0.02).

Conclusion: The high prevalence of hearing loss in the Sjogren syndrome supports the value of doing audiometric studies before excluding cranial nerve involvement in this disease. The correlation of sensorineural hearing loss with anticardiolipin antibodies must be investigated further.





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