几十年来,系统性红斑狼疮患者的听觉前庭功能障碍一直被低估。系统性红斑狼疮可同时影响听觉和前庭系统。已经提出了系统性红斑狼疮相关的听觉前庭功能障碍背后的几种潜在的病理生理机制。包括抗体介导的免疫反应,细胞介导的细胞毒性,免疫复合物在微血管中的沉积,中枢参与听觉前庭通路,以及系统性红斑狼疮治疗药物的耳毒性。目前可用的评估系统性红斑狼疮患者听觉前庭功能的测试既不特异也不敏感。然而,对于此类患者的前庭听觉功能障碍的治疗效果尚无共识.在这次系统审查中,我们电子搜索了PubMed,Embase,ClinicalKey,WebofScience,和ScienceDirect平台寻找合格的文章。首次检查日期为2023年12月29日,最终更新搜索日期为2024年6月11日。Further,我们用纽卡斯尔-渥太华量表对收录文章的质量进行了评价。根据上述系统审查过程,我们总结了目前可用的关于这些特征的证据,病理生理学,考试,与系统性红斑狼疮相关的听觉前庭功能障碍的治疗。此外,我们提出了一种特定的类固醇治疗方案来管理与系统性红斑狼疮相关的听觉前庭功能障碍.与系统性红斑狼疮相关的听觉前庭功能障碍可能对适当的治疗有反应,如果及时识别和管理疾病,则可能允许可逆性。因此,为临床医生提供临床相关证据,我们组织了这篇文献综述文章,以总结有关特征的可用证据,病理生理学,考试,系统性红斑狼疮患者的听力前庭功能障碍的治疗。最后,根据我们改良的类固醇治疗方案,我们希望为临床医生提供一种新的治疗策略,以治疗系统性红斑狼疮相关的听前庭功能障碍.
Audiovestibular dysfunction in patients with systemic lupus erythematosus has been underestimated for decades. Systemic lupus erythematosus can affect both the auditory and vestibular systems simultaneously. Several potential pathophysiological mechanisms behind systemic lupus erythematosus-related audiovestibular dysfunction have been proposed, including antibody-mediated immune responses, cell-mediated cytotoxicity, immune complex deposition in microvessels, central involvement in the audiovestibular pathway, and ototoxicity from medications used in systemic lupus erythematosus treatment. Currently available tests to evaluate audiovestibular function in systemic lupus erythematosus patients are neither specific nor sensitive. Nevertheless, there is no consensus regarding the efficacy of treatments for audiovestibular dysfunction in such patients. In this systematic
review, we electronically searched the PubMed, Embase, ClinicalKey, Web of Science, and ScienceDirect platforms to find eligible articles. The first inspection date was on 29 December 2023 and the final update search date was on 11 June 2024. Further, we rated the quality of the included articles with Newcastle-Ottawa Scale. Based upon the aforementioned systematic
review process, we have summarized the currently available evidence on the characteristics, pathophysiology, examination, and treatment of audiovestibular dysfunction related to systemic lupus erythematosus. Furthermore, we have proposed a specific steroid treatment protocol to manage audiovestibular dysfunction related to systemic lupus erythematosus. Audiovestibular dysfunction related to systemic lupus erythematosus may be responsive to adequate treatments, potentially allowing for reversibility if the disease is recognized and managed in a timely manner. Therefore, to provide clinically relevant evidence to clinicians, we have organized this literature
review article to summarize the available evidence on the characteristics, pathophysiology, examination, and treatment of audiovestibular dysfunction in patients with systemic lupus erythematosus. Finally, based on our modified steroid treatment protocol, we would like to provide a new treatment strategy to clinicians to manage systemic lupus erythematosus-related audiovestibular dysfunction.