الفهرس 
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Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease with multiorgan involvement that preferentially affects women from early adulthood through mid-adulthood.
We conducted this study to determine the frequency of asymptomatic sensorineural hearing loss (SNHL) in SLE and to determine its association with LDL cholesterol, demographic, clinical and laboratory disease parameters.
The present case-control study enrolled two matched groups; group of 50 SLE patients and other matched group was 20 healthy controls. The majority of the studied SLE patients in present study were females (94%) but males only (6%), their ages ranged from (17) to (57) old in homogenous with healthy controls who are distributed as (10%) males and (90%) females, their ages ranged from (19) to (59) years old with no statistically significant difference among cases and controls regarding sex and age. All patients were subjected to full clinical and laboratory investigations.
A sheet was formulated and applied to all patients subjected to this study. Lipid profile including low density lipoproteins (LDL) was done for all patients and controls.
Assessment of SLE disease activity will be done by using the systemic lupus erythematosus disease activity index (SLEDAI). The SLE disease severity was assessed using the Systemic Lupus International Collaborative clinics/America Collage of Rheumatology (SLICC/ACR) damage index
In current study, Triglyceride, Cholesterol, LDL cholesterol were significantly higher among studied SLE patients as compared with healthy controls with a statistically significant p-value= (0.034), (0.005), (0.002) respectively. All the studied healthy control participants had normal Hearing profile. The studied SLE patients hearing profile was assessed according to (hearing loss, Tympanogram and Emission test) in both right and left ears.
Asymptomatic SNHL was observed in 10 SLE patients (20%). Five (10%) of the 10 patients had unilateral SNHL while the other 10% had bilateral SNHL .Regarding patients who had unilateral SNHL, 4 patients(8%) had hearing loss at the right ear while one patient (2%) had hearing loss at the left ear . The most frequent severity was mild SNHL in both ears as we had 8 patients (16%) with mild SNHL, one patient (2%) with severe SNHL at the right ear and we had 3 patients (6%) with mild SNHL, one patient (2%) with moderate SNHL ,2 patients (4%) with severe SNHL at the left ear. Regarding to different frequencies; the numbers of patients with hearing losses were slightly higher among high frequencies as compared with medium and low frequencies.
Triglycerides, Cholesterol, LDL were significantly higher among SLE patients with SNHL as compared with non-SNHL patients with a statistically significant p-value= (0.022),(0.038),(0.020) respectively. Oral ulcers, serositis were significantly more prevalent in patients with ASNHL as compared with non-ASNHL patients with a statistically significant p-value=(0.036),(0.034) respectively. SLEADI and SLICC were significantly more higher in patients with ASNHL as compared with non-ASNHL patients with a statistically significant p-value=(0.028),(0.009) respectively.
We conclude that asymptomatic SNHL was found in minority of SLE patients and an association with high levels of low-density lipoprotein cholesterol levels suggesting atherosclerosis as a mechanism.