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All Journal E-Jurnal Medika Udayana ISM (Intisari Sains Medis) : Jurnal Kedokteran Bioscientia Medicina : Journal of Biomedicine and Translational Research JOURNAL OF COMMUNITY MEDICINE AND PUBLIC HEALTH RESEARCH Archives of The Medicine and Case Reports Bioscientia Medicina : Journal of Biomedicine and Translational Research Gema Kesehatan
I Made Wiranadha
Departemen Kesehatan THT-KL, Fakultas Kedokteran, Universitas Udayana/RSUP Sanglah, Bali
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Pulse Corticosteroid Therapy for the Complete Reversal of Severe Bilateral Sudden Sensorineural Hearing Loss in High-Activity Systemic Lupus Erythematosus: A Comprehensive Case Report Ida Ayu Ide Larassanthi Pratiwi; I Made Wiranadha; I Gede Wahyu Adi Raditya
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 5 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i5.1580

Abstract

Background: Sudden sensorineural hearing loss (SSNHL) is an alarming otologic emergency. While predominantly idiopathic, it can manifest as a rare, severe complication of autoimmune disorders, including systemic lupus erythematosus (SLE). The underlying pathophysiology in SLE-induced SSNHL often involves aggressive microvascular compromise and immune complex deposition. Case presentation: We present the case of a 21-year-old female with a history of SLE, congestive heart failure, and previous non-hemorrhagic stroke, who presented with acute-onset bilateral hearing loss of one day's duration. She exhibited high SLE disease activity with a MEX-SLEDAI score of 12. Initial pure-tone audiometry revealed very severe SSNHL in the right ear (Air Conduction [AC] 98.75 dB) and severe SSNHL in the left ear (AC 87.5 dB). Due to resource constraints, advanced immunological testing was unavailable; however, a severe lupus flare was confirmed clinically. The patient was immediately treated with intravenous methylprednisolone pulse therapy (500 mg/day) followed by an oral tapering regimen. Subsequent audiometric evaluations demonstrated rapid, complete audiological recovery to normal thresholds bilaterally. Conclusion: High-dose systemic corticosteroid pulse therapy, when initiated within 24 hours of symptom onset, can achieve complete reversal of severe bilateral SSNHL in patients with high-activity SLE. Rapid recognition and aggressive immunosuppression are vital to rescuing cochlear function, even in resource-limited clinical environments.
Co-Authors Agus Rudi Asthuta Eka Putra Setiawan I Dewa Gede Arta Eka Putra I Gede Wahyu Adi Raditya I Gusti Ayu Mahaprani Danastri Ida Ayu Ide Larassanthi Pratiwi Janris Sitompul Komang Andi Dwi Saputra Made Me Lina Kenwa Made Prani Windasari Ni Made Ary Wisma Dewi Ni Putu Oktaviani Rinika Pranitasari Pande Agus Parta Prananda Putri Citra Laksmi Darsana Putu Dian Ariyanti Putri Raditya, I Gede Wahyu Adi Sari Wulan Dwi Sutanegara Widia Danis Swari