Prednisone Effect to on Hearing Status of Systemic Lupus Erythematosus Patients

Systemic lupus erythematosus (SLE) is a chronic, multi-system, autoimmune disorder characterized by the production of autoantibodies and immune complexes deposition in tissue. Clinical manifestations may include skin, mucosa, joints, blood, heart, lungs, kidneys, central nervous system (CNS), immune system, and ears. SLE lin the cars can caused sensorineural hearing loss, tinnitus, and vertigo. This hearing disorder is commonly bilateral and has high frequencies. Prednisone is an oral corticosteroid with glucocorticoid and mineralocorticoid effects. Glucocorticoids have anti-inflammatory and immunosuppressive effects. The aim of this study was to evaluate the effect of prednisone in improving the degree of hearing loss in patients with SLE. This study was conducted in from March-May 2013, at tThe Hearing and Speech Disorder Clinic of Ear Nose Throat-Head and Neck Surgery, Dr. Hasan Sadikin Hospital Bandung, using quasi-experimental method with pre-post design in which the results were statistically calculated using Rank Spearman test. This study involved 28 subjects who had been diagnosed for SLE. Anamnesis, physical examination, and laboratory test were performed, followed by pure tone audiometry, tympanometry, and distortion product optoacoustic emissions (DPOAE). Subjects were given prednisone 1 mg/kgBW/day with a maximum dose of 6o mg/day. Re-evaluation was performed after 4 weeksof treatment. Before treatment, 26 subjects had mild hearing loss and 2 subjects had symmetric moderate hearing loss at high frequencies symmetrically. After therapy, 24 subjects became normal and 4 subjects still had hearing loss (Rs=0.734, p<0.01). In conclusion, prednisone can improve hearing status of SLE patients.