Patients with vitiligo at risk of hearing loss

A significant association exists between vitiligo and sensorineural hearing loss (SNHL), according to a recent study, which recommends audiologic assessment for early recognition and management of hearing loss in patients with vitiligo.

A systematic review and meta-analysis was carried out to assess the link between vitiligo and SNHL. The investigators searched the databases of Embase, Medline, PubMed, and Cochrane from inception to 28 June 2020 for studies that examined the association between SNHL and vitiligo.

Fourteen case-control studies were identified, including a total of 938 patients with vitiligo. Results of the meta-analysis revealed a significant association between SNHL and vitiligo (odds ratio [OR], 6.02, 95 percent confidence interval [CI], 3.41–10.62).

The significant association persisted even after adjusting for study quality (OR, 5.30, 95 percent CI, 1.53–18.35) and publication bias (OR, 3.45, 95 percent CI, 1.75–6.81).

This study was limited by heterogenous definition as well as measurement of hearing loss and racial differences, which could be potential source of bias.

A 2017 review found 21 studies and case reports revealing at least 102 cases of SNHL in patients with vitiligo. Most literature posited for a common causative aetiology related to melanocyte function. The researchers then suggested the evaluation of hearing function in these patients, including audiometry, otoacoustic emissions, and Auditory Brainstem Response measurements. [Eur Arch Otorhinolaryngol 2017;274:2367-2372]

“Vitiligo is a common depigmenting disorder caused by the autoimmune destruction of melanocytes,” the investigators said. “Some evidence suggests the involvement of melanocytes in the auditory system in the disease process.”