Sjögren Syndrome Patients Show Early Signs of Hearing Loss, Study Finds

Women with Sjögren syndrome show particularly high levels of hearing loss and language recognition impairments compared to healthy women or those with rheumatoid arthritis (RA), study reports.

The research, “Early hearing loss detection in rheumatoid arthritis and primary Sjögren syndrome using extended high frequency audiometry,” was published in the journal Clinical Rheumatology.

Hearing loss is a common feature in patients with autoimmune diseases. It is hypothesized that the condition is caused by autoantibodies that damage the inner ear, but the exact mechanisms are not fully known.

In an attempt to understand the audiological behavior of patients with rheumatoid arthritis and primary Sjögren syndrome with those of healthy subjects, researchers recruited patients from the Center of Specialties in Arthritis and Rheumatology at the University Hospital Dr. José Eleuterio González in Monterrey, Mexico, between August 2014 and August 2016.

The study included 117 RA patients and 60 with primary Sjögren syndrome, and healthy control group of 251 participants. All were women, 19 to 65 years old.

Patients with RA and primary Sjögren syndrome were undergoing treatment for their autoimmune condition with methotrexate, prednisone, and hydroxychloroquine.

“Every subject underwent a series of studies including high-frequency audiometry, speech audiometry, and tympanometry. The high-frequency audiometry measured 250 to 16,000 Hz,” researchers wrote.

They defined normal hearing as “the perception of a sound stimulus at an intensity less than or equal to 20 dB [decibel, the frequently used measure for sound level] in all frequencies studied.”

Compared to healthy control participants, both RA and primary Sjögren syndrome patients showed significant hearing impairment. But those with primary Sjögren syndrome had a higher prevalence of hearing loss than those with RA.

Specifically, RA hearing loss was present in 36.8 percent of patients with frequencies between 500–3,000 Hz, while in this range the hearing loss affected 60 percent of the Sjögren syndrome patients.

In all other frequencies tested, 4,000 to 8,000 Hz and 10,000 to 16,000 Hz, hearing loss was always more prevalent in Sjögren syndrome patients – 70 percent and 100 percent, respectively – compared to those with RA – 68.4 percent and 94.9 percent.

Overall, “the comparison of the results of speech audiometries between the subjects with RA and PSS [primary Sjögren syndrome] shows a greater auditory and language recognition repercussion in the second group,” researchers wrote.

“In addition, the differences between the tympanometric curves show how the RA involves the middle ear in a higher percentage compared to PSS [Sjögren syndrome],” they added.

Overall, these results suggest that patients with Sjögren syndrome have a deeper hearing loss than those with RA, supporting the premise of increased burden on these patients’ auditory and speech recognititon capabilities.

“We consider that sensorineural hearing loss is an important symptom in autoimmune diseases and suggest performing audiometric studies within the routine protocol for the study of autoimmune disease patients,” the study concluded.