Rheumatoid arthritis does not increase risk of hearing loss
Editor: A previous study indicated that having rheumatoid arthritis
increases the risk of hearing loss. A recent study by researchers at
Mayo Clinic contradicts the previous finding. Here's the press release.
Mayo Clinic researchers have found that people with rheumatoid arthritis
are no more likely to have hearing loss than other members of the
general population. The finding is contrary to previous study results
that linked the disease to elevated risk of hearing problems. The study
results will be presented Monday at the American Auditory Society annual
meeting in Scottsdale, Ariz.
"This is very good news for rheumatoid arthritis patients,"
says Eric Matteson, M.D., Mayo Clinic rheumatologist and senior study
researcher. "Patients with rheumatoid arthritis actually have
preserved hearing and are no more susceptible to hearing loss than those
who do not have the disease; there is no measurable difference with
standard testing. This was surprising. I expected to see more hearing
loss in rheumatoid arthritis patients."
The study included 29 patients ages 40 to 69 who had rheumatoid
arthritis for more than five years, categorized by decades of age. The
researchers compared them to 30 participants of the same gender and age
categories who did not have rheumatoid arthritis. All participants had
comprehensive hearing tests and questionnaires to measure hearing and
dizziness handicaps and assess their overall health. Seventeen of 29
patients with rheumatoid arthritis had abnormal hearing for at least one
sound frequency (a measure of pitch), as did 14 of 30 of those without
Dr. Matteson notes, however, that the findings do not mean that
hearing loss is never related to rheumatoid arthritis. "Hearing
loss can be a symptom of rheumatoid arthritis, but it doesn't seem to be
more of a problem than in the general population," he says.
The researchers found that though no objective difference was
detected in comprehensive hearing evaluations of rheumatoid arthritis
patients compared to those without the disease, the rheumatoid arthritis
patients were more likely to perceive that they had hearing problems.
This phenomenon was most pronounced in those who had more severe
rheumatoid arthritis and had disabilities due to the disease.
"Perhaps this is due to severe disability and thus an overall
feeling of helplessness," says Dr. Matteson. "People who have
profound disability may generalize their disabilities to other areas of
the body - they just feel worse overall."
Among the rheumatoid arthritis patients who had hearing loss, most
often the loss was partial and due to nerve problems in the inner ear
(sensorineural). The cause of this loss is uncertain, but may be due to
factors such as noise exposure according to the researchers. In
addition, the hearing loss may be related to an autoimmune attack in
which the immune system attacks the cochlea, the inner ear cavity
containing hair cells and the nerves which connect the cochlea to the
brain. The researchers also noted a possible link between the hearing
loss and rheumatoid arthritis medications, as patients who took
hydroxychloroquine were somewhat more likely to have hearing problems
than other study participants.
Critical next steps in this research, according to Dr. Matteson, are
a large study of hearing loss among members of the general population
with and without rheumatoid arthritis, in addition to a study to assess
the impact of rheumatoid arthritis medications on hearing.
The research team also included Christine Halligan, M.D.; Christopher
Bauch, Ph.D.; Robert Brey, Ph.D.; Sara Achenbach and William Bamlet, all
of Mayo Clinic.