When rheumatism damages the inner ear
Inflammatory rheumatic diseases, from which one and a half million people in Germany suffer, not only attack the joints. The little-known consequences also include damage to the inner ear. Some forms of rheumatism can even lead to sudden hearing loss, as a rheumatism expert from the German Society for Rheumatology (DGRh) explains on the occasion of World Hearing Day.
Classic rheumatoid arthritis, rheumatoid arthritis (RA), often begins at the age of 50 to 70 years. During this time, the hearing of many people also deteriorated. "It is therefore difficult to assess whether the RA promotes the development of hearing loss in old age," explains Professor Dr. med. Hendrik Schulze-Koops, President of the German Society for Rheumatology (DGRh) and Senior Rheumatologist at the Ludwig Maximilians University Hospital in Munich.
However, many epidemiological studies indicate that people with RA suffer from hearing disorders more often than others.
According to the expert, the relationships have so far been little researched. It is unclear whether the joints between the ossicles, which amplify the sound in the middle ear, are affected. It is also conceivable that the recipient in the inner ear will be affected by the disease. “However, one can assume that the inflammation in RA and other inflammatory diseases damage the nervous system and this affects hearing. For example, there are studies on smell and systemic lupus erythematosus (SLE) that prove this, ”explains the expert.
RA is just one of several rheumatic diseases in which the immune system attacks joints and other body structures with antibodies instead of protecting it. Another is systemic lupus erythematosus (SLE), which affects around 30,000 people in Germany. It is often younger adult women. A visible sign of the SLE can be the so-called butterfly lichen, which is accompanied by reddish scaly surfaces on the face. However, the disease is not limited to the skin. It attacks various organs, including the inner ear. "Pathologists have identified antibodies and immune complexes in the inner ear that cause circulatory disorders or directly damage the sensory cells," reports Professor Schulze-Koops. In severe cases there is a sudden hearing loss in one ear. "Fortunately, timely treatment can often prevent this," said the expert, "which is why patients urgently need to be in the hands of rheumatologists." Those affected often have to take lifelong medications that slow down excessive immune system reactions.
The rare inflammatory rheumatic granulomatosis with polyangiitis also damages the hearing. With this disease, small inflammatory nodules accumulate throughout the body, which damage the tissue. The connection between the middle ear and throat is also affected, which favors middle ear infections. In Germany, a few hundred people have contracted it. "Hearing disorders are very common in this disease," explains Professor Schulze-Koops.
In principle, the expert advises all people with rheumatism to have their hearing checked regularly. Professor Schulze-Koops explains: "A deterioration in hearing performance can indicate that the treatment of the disease is not optimal and the dose of the medication has to be checked." It is crucial that the patients get to the specialist as early as possible and give them one tailored treatment. This is the only way to prevent long-term damage.