Researchers from Spain investigated the prevalence of audiovestibular disorders in patients with primary Raynaud’s phenomenon (RP) and RP secondary to systemic sclerosis (SSc).
According to the results, the presence of auditory and vestibular dysfunction was only reported in patients with RP secondary to SSc but not in patients with primary (idiopathic) RP.
“These findings support the benign nature of the primary RP when compared with that associated with connective tissue diseases. It is possible that the presence of underlying vascular damage, even in the early stages of the disease, may be responsible for the presence of audiovestibular manifestation in patients with RP secondary to SSc,” the researchers wrote in the Journal of Clinical Medicine.
Four of 37 patients with RP secondary to SSc complained of subjective hearing loss and presented with abnormal hearing loss after having an audiogram. These patients had positive antinuclear antibodies, and 3 of them showed abnormalities on capillaroscopy, such as giant capillaries, hemorrhages, avascular areas, and neoangiogenesis.
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The most common symptoms reported by patients with RP secondary to SSc were dizziness and vertigo.
The presence of sensorineural hearing loss, which was observed in 4 patients with RP secondary to SSc, was associated with a 7.03 times greater probability of having secondary RP compared with control subjects.
No sensorineural hearing loss was registered in any patient with primary RP, and only 1 subject from the control group had abnormal hearing loss in the audiogram.
Regarding vestibular and postural alterations, 5 of 27 patients in the secondary RP group, but none in the primary RP or control group, had an abnormal caloric test.
Moreover, patients with RP secondary to SSc had significantly lower horizontal canal gains than control subjects. The results of the abnormal clinical sensory integration and balance testing (CTSIB) and computerized dynamic posturography (CDP) were more frequently altered in the secondary RP group than in the control group.
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The findings suggest that patients with abnormal CTSIB or CDP had an 18.6 times greater probability of having secondary RP compared with control subjects.
Three patients with RP secondary to SSc had saccades, while none in the primary RP or control groups showed this alteration, and 3 patients had concomitant mild hearing loss and vestibular disorders.
The study enrolled 57 patients with RP (primary RP, 20; RP secondary to SSc, 37) and 57 matched controls.
Reference
Amor-Dorado JC, Martín-Sanz E, Franco-Gutiérrez V, et al. Audiovestibular manifestations in patients with primary Raynaud’s phenomenon and Raynaud’s phenomenon secondary to systemic sclerosis. J Clin Med. Published online April 30, 2023. doi:10.3390/jcm12093232
