title: Sensorineural hearing loss in systemic lupus erythematosus: case report and literature review.
abstract: OBJECTIVE
  We present a case of systemic lupus erythematosus with symptomatic sensorineural hearing loss which was successfully treated with azathioprine, as assessed both clinically and radiologically. We also present a review of the relevant literature.
  
  
  METHODS
  A woman with systemic lupus erythematosus presented with sensorineural hearing loss, initially on the right and subsequently developing on the left over several months. An audiogram revealed profound neurosensory hearing loss bilaterally. The patient was treated with prednisone 60 mg daily and azathioprine 200 mg daily. An improvement on the left was noted on follow-up audiography as well as on magnetic resonance imaging of the internal auditory canals and surrounding structures.
  
  
  CONCLUSIONS
  Sensorineural hearing loss has been described in autoimmune disorders but is rare. Aural symptoms have been described, with varying incidences (0-57.5 per cent), in systemic lupus erythematosus. However, symptomatic sensorineural hearing loss is rare in systemic lupus erythematosus. Prednisone appears essential when an immunological or vasculitic cause is found. The use of azathioprine should be considered, as well as follow-up with magnetic resonance imaging to detect improvement.
authors.affiliation: Section of Rheumatology, McMaster University, Hamilton, Ontario, Canada. naderkhalidi@sympatico.ca
authors.forename: N A
authors.initials: NA
authors.lastname: Khalidi
authors.forename: R
authors.initials: R
authors.lastname: Rebello
authors.forename: D D
authors.initials: DD
authors.lastname: Robertson
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage; D000963:Antimetabolites / Q000627:therapeutic use; D001301:Audiometry, Pure-Tone / Q000379:methods; D001379:Azathioprine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D009759:Nystagmus, Pathologic / Q000175:diagnosis / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage
chemical_list: D000925:Anticoagulants; D000963:Antimetabolites; D014859:Warfarin; D001379:Azathioprine; D011241:Prednisone