title: Hearing loss as the presenting feature of systemic vasculitis.
abstract: Hearing loss, both sensorineural and conductive, is a well-recognized manifestation of systemic vasculitis, yet has only infrequently been described as its initial presentation. We describe three cases in which hearing loss preceded the diagnosis of systemic vasculitis by a period of a few weeks to more than 6 months. While steroid therapy was initiated immediately in one of the cases, comprehensive immunosuppressive therapy was given only after additional manifestations compatible with vasculitis appeared, allowing for a diagnosis of Wegener's granulomatosis in two of the cases and undifferentiated vasculitis, in the third. Hearing improved in all patients, albeit, residual dysfunction remained. Prompt referral for a complete rheumatologic workup in cases of unexplained hearing loss would allow for a timely diagnosis of a collagen vascular disease and facilitate early initiation of systemic therapy, possibly yielding better audiological results.
authors.affiliation: Department of Internal Medicine F and Rheumatic Disease Unit, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Merav
authors.initials: M
authors.lastname: Lidar
authors.forename: Eldar
authors.initials: E
authors.lastname: Carmel
authors.forename: Yona
authors.initials: Y
authors.lastname: Kronenberg
authors.forename: Pnina
authors.initials: P
authors.lastname: Langevitz
mesh_terms: D005260:Female; D034381:Hearing Loss / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014657:Vasculitis / Q000150:complications* / Q000473:pathology*