両側感音難聴が初発症状であった全身性エリテマトーデス（ＳＬＥ）の一症例

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  • Bilateral Sensorineural Hearing Loss as Initial Signs in Systemic Lupus Erythematosus; a Case Report.

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A 13-year-old boy complained of progressive bilateral hearing impairment with a three-month history of recurrent fever. At first, he was treated with bethamethasone 3mg daily as sudden deafness, but his hearing loss was not improved. He developed high fever associated with hearing loss and abdominal pain one month later. Then he was diagnosed with systemic lupus erythematosus (SLE) on the basis of clinical findings and laboratory data. His hearing loss was bilateral moderate hearing loss, which was greater in the high frequency tones with positive recruitment phenomenon. He was treated with predonisolone 60mg daily, and then his hearing impairment was gradually improved. Four weeks later, when predonisolone was reduced to 40mg daily, he developed hearing impairment again. Then he was treated by 6 series of plasma exchange, immmunosuppressive therapy and hyperbolic oxygen therapy in addition to predonisolone 40mg daily. His hearing impairment was gradually improved.<br>Immune-mediated sensorineural hearing loss could occur due to various causes, so the clinical feature should be different in each case. In this case hearing impairment was immune-mediated and one of symptoms which occurred in the very early stage of SLE responsive to the treatments including steroids.

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