title: Study of audiovestibular dysfunction in children with systemic lupus erythematosus.
abstract: OBJECTIVE
  Inner ear dysfunction in systemic lupus erythematosis patients has been reported but audiovestibular involvement is not well documented especially in pediatrics. This study was designed to evaluate silent audiovestibular dysfunction among SLE children.
  
  
  METHODS
  Case control study examined in allergy and immunology clinic; pediatrics hospital and audiovestibular clinic; Ain Shams University from January 2009 to December 2010. Thirty-five systemic lupus erythematosus children (diagnosed according to American College of Rheumatology); age group 8-16 years, were randomly selected. Five of them were excluded due to one or more exclusion criteria (previous otitis media, stroke, lupus cerebritis, meningitis or encephalitis, audiovestibular symptom). Ten of them refused enrollment or could not complete full battery. Seventeen females and three males, mean age 12.9 ± 2.6 years, completed the study. Control group included 20 normal subjects, age and sex matched. Full clinical assessment, basic audiological evaluation and vestibular testing (videonystagmography VNG and computerized dynamic posturography CDP) were conducted for children included in the study.
  
  
  RESULTS
  Five systemic lupus erythematosus patients had sensorineural hearing loss strongly associated with +ve antiphospholipid antibody and two had conductive hearing loss. Two children in control group had conductive hearing loss (p=0.05). Abnormal VNG findings was significantly higher among systemic lupus erythematosus children (40%) compared to controls (0%) and associated with +ve antiphospholipid antibodies (χ(2)=10, p=0.002, Fisher exact test=0.003). Twenty-five percentage of systemic lupus erythematosus children had abnormal CDP findings reflecting impaired balance function associated with positive antiphospholipid antibodies showing significant statistical difference compared to controls (0% affection) (χ(2)=5.7, p=0.017, Fisher exact test=0.047).
  
  
  CONCLUSIONS
  Silent audiovestibular dysfunction is prevalent among systemic lupus erythematosus children especially those positive for antiphospholipid antibodies necessitating routine regular evaluation.
authors.affiliation: Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. ghadawael2006@yahoo.com
authors.forename: Ghada Ibrahim
authors.initials: GI
authors.lastname: Gad
authors.forename: Somaia Tawfik
authors.initials: ST
authors.lastname: Mohamed
authors.forename: Khaled Salah
authors.initials: KS
authors.lastname: Awwad
authors.forename: Rehab Fetoh
authors.initials: RF
authors.lastname: Mohamed
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D017152:Antibodies, Antiphospholipid / Q000097:blood / Q000276:immunology*; D001301:Audiometry, Pure-Tone; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D015897:Comorbidity; D005260:Female; D006314:Hearing Loss, Conductive / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D006776:Hospitals, Pediatric; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D008297:Male; D015995:Prevalence; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D014724:Vestibular Function Tests
chemical_list: D017152:Antibodies, Antiphospholipid
keywords: Antiphospholipid antibody; Audiovestibular; Systemic lupus erythematosus