Sensorineural hearing loss as a common manifestation in patients with mixed connective tissue disease

Hajas et al. recently examined the prevalence of sensorineural hearing loss (SNHL) in patients with mixed connective tissue disease (MCTD) [1]. Auditory symptoms are relatively frequent, but apparently underestimated, in patients with connective tissue disease [2]. SNHL is rapidly progressive and accompanied by vertigo and/or tinnitus in some patients, but it is often asymptomatic. Since SNHL can be treated successfully in some patients when it is identified in an early disease phase, it is important for rheumatologists to be aware of this complication. SNHL has been observed in patients with various connective tissue diseases, including systemic lupus erythematosus (SLE) [3–8], Sjögren’s syndrome [9], systemic sclerosis [10], Wegener’s granulomatosis [11] and primary antiphospholipid syndrome (APS) [12], but SNHL in association with MCTD has never been described. In addition, vasculitis and immune complexmediated inflammation are reported as potential pathogenic mechanisms for SNHL, although the involvement of these underlying mechanisms remains a mere hypothesis.