Inner Ear Hemorrhage in Systemic Lupus Erythematosus

Introduction: Systemic lupus erythematosus (SLE) is a chronic inflammatory disease with multiorgan involvement based on an autoimmune process. SLE, although rare, is associated with comorbid vertigo. Vertigo in SLE is caused by a disturbance in the balance system in the inner ear. Few journals discuss SLE related to vertigo. We will report a case SLE with complaints of recurrent vertigo. Case: A-37-year-old woman came with complaints of recurrent vertigo since 1 day ago with a duration of about 15 minutes associated with nausea, vomiting and nystagmus. Patient did not complain tinnitus or hearing disorders. The patient has been diagnosed as SLE since two years ago. The physical examination showed normal and Neuro-otological examination revealed nystagmus horizontal unidirectional, negative skew deviation test, positive Head Impulse Test (HIT). Conclusion: Patients with a diagnosis of SLE can find comorbid peripheral vestibular disorders such as vertigo where there is an antibody mechanism that can damage the inner ear. Treatment of audiovestibular symptoms is usually strongly associated with systemic conditions and in patients with vertigo used betahistine to treatment. Keywords: SLE, Inner Ear, Vertigo.

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Systemic Lupus Erythematosus and hearing disorders: Literature review and meta-analysis of clinical and temporal bone findings

Journal of International Medical Research ◽

10.1177/0300060516688600 ◽

2017 ◽

Vol 45 (5) ◽

pp. 1470-1480 ◽

Cited By ~ 27

Author(s):

A Di Stadio ◽

Massimo Ralli

Keyword(s):

Systemic Lupus Erythematosus ◽

Literature Review ◽

Inner Ear ◽

Temporal Bone ◽

Lupus Erythematosus ◽

Clinical Symptoms ◽

Meta Analysis ◽

Autoimmune Response ◽

Systemic Lupus ◽

Cogan Syndrome

Objective This literature review and meta-analysis was performed to evaluate the correlations among hearing and vestibular clinical symptoms, temporal bone findings, and pathological mechanisms in patients with systemic lupus erythematosus (SLE). Study design Relevant papers in the literature were retrospectively reviewed. Clinical hearing aspects in patients with SLE and relevant temporal bone studies in the same field were analyzed. Methods PubMed and Google Scholar searches were performed using the following keywords: “auto-immune disease,” “systemic lupus erythematosus (SLE),” “hearing loss,” “temporal bone study,” “vertigo,” “dizziness,” “tinnitus,” “ear symptoms,” “treatment,” “diagnosis,” “symptoms,” “etiopathogenesis,” “Wegener granulomatosis,” “Sjogren,” “polyarteritis nodosa,” “Cogan syndrome,” and “granulomatosis.” Also included were reviews in which the following terms were present: “SLE,” “temporal bone,” and “hearing symptoms.” Review and conclusion This literature review and meta-analysis focused on the pathological mechanisms through which SLE can damage inner ear structures and determinate hearing and vestibular symptoms. The main mechanisms involved in inner ear damage include the autoimmune response, deposition of immune complexes in the vessels and, to a lesser extent, cytotoxic damage.

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Organized Intraglomerular Deposits in NZB Mouse Disease

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100066772 ◽

1971 ◽

Vol 29 ◽

pp. 544-545

Author(s):

Francis R. Comerford ◽

Alan S. Cohen

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Antinuclear Antibodies ◽

Human Systemic Lupus Erythematosus ◽

Systemic Lupus ◽

Glomerular Lesion ◽

Ultrastructural Studies ◽

Dense Deposits ◽

Experimental Nephritis ◽

Glomerular Lesions

Mice of the inbred NZB strain develop a spontaneous disease characterized by autoimmune hemolytic anemia, positive lupus erythematosus cell tests and antinuclear antibodies and nephritis. This disease is analogous to human systemic lupus erythematosus. In ultrastructural studies of the glomerular lesion in NZB mice, intraglomerular dense deposits in mesangial, subepithelial and subendothelial locations were described. In common with the findings in many examples of human and experimental nephritis, including many cases of human lupus nephritis, these deposits were amorphous or slightly granular in appearance with no definable substructure.We have recently observed structured deposits in the glomeruli of NZB mice. They were uncommon and were found in older animals with severe glomerular lesions by morphologic criteria. They were seen most commonly as extracellular elements in subendothelial and mesangial regions. The deposits ranged up to 3 microns in greatest dimension and were often adjacent to deposits of lipid-like round particles of 30 to 250 millimicrons in diameter and with amorphous dense deposits.

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