Audiological profile in primary Sjogren’s syndrome in an Indian setting.

Thanooja, C V (2012) Audiological profile in primary Sjogren’s syndrome in an Indian setting. Masters thesis, Christian Medical College, Vellore.


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Objectives This is a prospective study to determine the frequency and the profile of hearing loss among patients with confirmed diagnosis of primary Sjogren’s Syndrome (pSS) in an Indian setting. Secondary objective is to analyse the correlation between hearing loss and immunological variables which includes Anti SS-A antibody, Anti SS-B antibody, Anticardiolipin, Complement C3, C4 and Cryoglobulins. Literature Review Sjogrens Syndrome is a cell mediated autoimmune disease which primarily affects the exocrine glands. The disease primarily affects women, with a very high female-male ratio of 9:1 and is seen in 40-60 years age group (1). Hearing loss may be the first otological manifestation of this autoimmune disease (1). Sensorineural hearing loss (SNHL) is found in half patients with pSS and is correlated with presence of anticardiolipin (ACA) antibodies (1) Most studies done in the western countries ( 2,3,4,5) have shown that pSS is associated with significant sensorineural hearing loss(3). SNHL was found to be associated with disease duration, there was no correlation with age, presence of autoantibodies, systemic manifestations of disease, or drug therapy. Some of the studies (2,4) showed an association of hearing loss with immunological variables such as anti SS-A, anti SS-B, anti-phosholipid antibodies and anti- nuclear antibodies. This study is undertaken to see if the audiological profile is similar to the reported literature. Methodology All consecutive patients with established diagnosis of pSS as per the Modified American European Classification Criteria between 20-60 years attending at the Clinical Immunology and Rheumatology OPD of CMC Vellore were referred to the AudioVestibular clinic over a period of 10 months. These patients who fit into the inclusion, exclusion criteria underwent a history taking with detailed structured questionnaire and ENT examination, necessary audiological and blood tests. Frequency of hearing loss, its profile, relationship with immunological tests were analysed. All the data were entered into an excel sheet using Microsoft Excel and was analysed using SPSS version 11.0 Results and Conclusions: The frequency of primary Sjogren’s disease is high in this tertiary care rheumatology clinic in this Indian setting. The frequency of audiometrically confirmed hearing loss in pSS is 78.38 %. The commonest type of hearing loss was minimal to mild sensorineural hearing loss. The high frequencies were more affected than lower frequencies. The commonest tympanometry finding was A type curve . Acoustic reflex was absent in 18.92%. The frequency of hearing loss was found to be more in the 1st year after onset of SS than after 5 year duration. There seems to be no co-relation between hearing loss and age, sicca symptoms, systemic symptoms, immunological test results in pSS.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Audiological profile; primary Sjogren’s syndrome; hearing loss
Subjects: MEDICAL > Otolaryngology
Depositing User: Devi S
Date Deposited: 13 Jul 2017 06:10
Last Modified: 13 Jul 2017 06:10

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