The Auditory Manifestations of Autoimmune Rheumatologic Diseases: A Review of Current Evidence

Background: It is becoming increasingly recognized that rheumatologic diseases and sensorineural hearing loss (SNHL) are linked. These autoimmune disorders can affect the auditory system through both disease-related immune dysregulation and medication-induced ototoxicity. The latest findings on auditory involvement in patients with autoimmune rheumatologic conditions are summarized in this review Methods: This narrative review was conducted using PubMed, focusing on articles published in English between 2010 and 2024. Clinical, experimental, and epidemiological studies describing hearing outcomes in autoimmune conditions were included. MeSH and keywords related to autoimmune diseases, SNHL, auditory dysfunction, and cochlear implantation were used. Results: Autoimmune-mediated SNHL results from immune complex deposition, vasculitis, antibody- mediated cytotoxicity, and inflammatory injury to cochlear structures. Rheumatoid arthritis, systemic lupus erythematosus, primary Sjögren’s syndrome, vasculitis, juvenile idiopathic arthritis, IgG4-related disease, and Behçet’s disease all demonstrate variable yet significant auditory involvement. Commonly used medications for these diseases, such as calcineurin inhibitors, methotrexate, cyclophosphamide, and antimalarials, may also cause ototoxicity. Cochlear implantation offers effective rehabilitation for severe or refractory SNHL. However, autoimmune- related cochlear fibrosis or ossification may limit outcomes, highlighting the need for prompt diagnosis. Conclusion: Hearing is affected in patients with rheumatologic disease and those using immunosuppressants as treatment. Routine audiologic monitoring, early identification of auditory symptoms, and personalized therapeutic planning are essential. Further prospective research is needed to clarify the mechanisms and optimize treatment protocols for autoimmune-associated hearing loss.