Is tinnitus (ringing in the ears) associated with Systemic Lupus Erythematosus (SLE)?

From the Guidelines

Tinnitus is not directly associated with Systemic Lupus Erythematosus (SLE) as a common neuropsychiatric manifestation, according to the most recent and highest quality evidence available 1. When considering the relationship between SLE and tinnitus, it's essential to focus on the overall management of lupus activity and its potential effects on the nervous system.

• The study by 1 provides recommendations for the diagnosis, prevention, and treatment of neuropsychiatric SLE manifestations, which may indirectly relate to tinnitus symptoms.
• However, tinnitus itself is not explicitly mentioned as a common manifestation of SLE in this study.
• Given the lack of direct evidence linking SLE to tinnitus, treatment should focus on controlling underlying lupus activity with medications such as hydroxychloroquine, corticosteroids, or immunosuppressants, as needed.
• For patients experiencing tinnitus, symptom management may involve sound therapy, cognitive behavioral therapy, and avoiding triggers like loud noises, but this should be approached on a case-by-case basis.
• Regular monitoring of hearing is crucial for patients with lupus, as early intervention may help prevent permanent damage, although this is not specifically addressed in the context of tinnitus by 1.
• Maintaining overall lupus disease control through medication adherence and regular follow-ups remains the most effective strategy for managing potential lupus-related symptoms, including those that may be indirectly related to tinnitus.

From the Research

Association between Tinnitus and Systemic Lupus Erythematosus (SLE)

• There is no direct evidence in the provided studies to suggest a strong association between tinnitus and Systemic Lupus Erythematosus (SLE) 2, 3, 4, 5.
• The studies primarily focus on the diagnosis and management of tinnitus, discussing its common causes, such as sensorineural hearing loss, and its treatment options, including cognitive behavior therapy and sound therapy 2, 3, 4, 5.
• One study discusses Systemic Lupus Erythematosus, its diagnosis, and management, but does not mention tinnitus as a symptom or associated condition 6.
• The lack of direct evidence suggests that there may not be a well-established link between tinnitus and SLE, but it does not rule out the possibility of SLE patients experiencing tinnitus as a symptom of another underlying condition or as a side effect of treatment.

Tinnitus Diagnosis and Management

• Tinnitus is a common symptom that can be caused by various factors, including otologic, vascular, neoplastic, neurologic, pharmacologic, dental, and psychological factors 2, 3, 4, 5.
• The diagnosis of tinnitus involves a thorough history, head and neck examination, and audiometric testing to identify an underlying etiology 2, 3, 4, 5.
• Treatment options for tinnitus include cognitive behavior therapy, sound therapy, and tinnitus retraining therapy, although evidence for their effectiveness is not always conclusive 2, 5.

Systemic Lupus Erythematosus (SLE)

• SLE is an autoimmune disease that affects many systems, including the skin, musculoskeletal, renal, neuropsychiatric, hematologic, cardiovascular, pulmonary, and reproductive systems 6.
• The diagnosis of SLE involves meeting at least four of the American College of Rheumatology's classification criteria, which can be done with 95% specificity and 85% sensitivity 6.
• Treatment of SLE typically involves hydroxychloroquine, low-dose glucocorticoids, and immunosuppressive or cytotoxic agents, depending on the severity of the disease and the systems affected 6.