Auditory function in patients with juvenile idiopathic arthritis

ABSTRACT

Some rheumatologic diseases like rheumatoid arthritis, systemic lupus erythematosis and vascuilitis can affect the auditory system through either their pathological mechanisms or as a side effect of the medications. The aim of the current work was to study the auditory function in patients with juvenile idiopathic arthritis [JIA]. Middle ear function and cochlear function were examined in a study group formed of 30 patients with JIA and a control group formed of 15 normal hearing children through measuring the middle ear pressure, acoustic reflex, hearing sensitivity by pure tone audiometry and distortion product otoacoustc emissions [DPOAEs]. All patients had type A tympanograms and intact acoustic reflex, indicating normal middle ear function. Although the majority of the patients had hearing sensitivity that was normal in the speech frequencies [500, 1000, 2000 and 4000 Hz], the mean hearing sensitivity in the patients with JIA was statistically significant higher than that in the age and sex matched control group. Moreover, 63% of patients with JIA had bilateral and symmetrical sensorineural [SNHL] hearing loss of mild degree at 8000 Hz. While the entire control group had normal DPOAE, which is a specific test for cochlear function, 65% of patients with JIA had abnormal DPOAE, reflecting cochlear pathology. In addition, the amplitude of DPOAEs, was statistically significant smaller in patients with JIA than that in the control group. Statistically significant correlation was found between cochlear function as measured by DPOAE and disease duration, articular index, systemic onset and presence of deformity. JIA affects the auditory system, targeting the cochlea and leads to mild SNHL. We recommend regular audiologic follow up as a part of general follow up in patients of JIA