TY - JOUR T1 - Frequency of Auditory Involvement and of Associated Factors in Patients With Juvenile Idiopathic Arthritis JO - Reumatología Clínica (English Edition) T2 - AU - Céspedes Cruz,Adriana Ivonne AU - Méndez Núñez,Myriam AU - Solís Vallejo,Eunice AU - Zeferino Cruz,Maritza AU - Torres Jiménez,Alfonso Ragnar AU - Ocampo Sánchez,Verónica AU - Flores Meza,Beatriz AU - Quintana Ruiz,Norma SN - 21735743 M3 - 10.1016/j.reumae.2017.07.009 DO - 10.1016/j.reumae.2017.07.009 UR - https://reumatologiaclinica.org/en-frequency-auditory-involvement-associated-factors-articulo-S2173574319300267 AB - IntroductionJuvenile idiopathic arthritis (JIA) is a chronic autoimmune disease characterised by the presence of arthritis in children under 16 years of age for more than 6 weeks in the absence of any other known cause.The extra-articular manifestations, especially in the audiovestibular system, are related to the involvement of the joints of the ossicular chain as a result of the inflammatory process in the synovium. Previous clinical studies in paediatric patients have shown conductive or sensorineural hearing loss. ObjectiveThe aim of this study was to assess the frequency of hearing impairment and of associated factors in patients with JIA. MethodologyA prospective, analytical study was conducted from January 2013 to August 2014 in 62 patients with JIA aged between 5 and 15 years. The study was approved by the local ethics committee and parents signed their informed consent. All subjects underwent audiological examination involving otomicroscopy, audiometry, tympanometry, stapedius reflex and test for transient otoacoustic emissions (TOAE); rheumatologic evaluation included joint examination and the application of a measure of functional ability (disability) using the Childhood Health Assessment Questionnaire (CHAQ).Measures of central tendency and of dispersion were used (chi-square for associations and P<.05 for statistical significance). ResultsSixty-two patients were included: 56 girls and 6 boys, mean age 11.9 years and mean disease duration of 3.4 years; 46% had rheumatoid factor (RF)-positive polyarticular JIA, 40% had RF-negative polyarticular JIA, 15% had disease of systemic onset and 3% had oligoarthritis. Active disease was found in 29 patients and 33 were in remission with medication.Of the total of 124 ears evaluated according to the Jerger classification for tympanometry, abnormal findings were observed in 78 that were type As and in 1 that was type Ad, whereas there were 45 type A ears. Hearing loss was disclosed by speech audiometry, rather than by pure tone audiometry. The TOAE were absent in 4% of those assessed and the stapedius reflex was absent in less than 10%.Factors that had a positive correlation with hearing impairment were RF-positive polyarticular JIA, disease duration, degree of disability and the erythrocyte sedimentation rate level (P<.000). ConclusionThe presence of an abnormal tympanogram suggested early involvement in the structure of the tympanic-ossicular complex; however, 3.4 years later, no hearing loss had been reported. ER -