Systemic Polyarteritis Nodosa as the Cause of Sudden Onset Bilateral Sensorineural Hearing Loss Following Lassa Virus Infection

Abstract : Lassa virus (LASV) causes a severe, often fatal hemorrhagic disease in endemic regions of Africa and sudden-onset sensorineural hearing loss is a consequence of infection in approximately 30 percent of recovering patients. The mechanism of hearing loss in LASV-infected patients has not been identified. Here, we show that a cynomolgus macaque experimentally infected with Lassa virus who survived the initial infection, developed bilateral sensorineural hearing loss, confirmed by brainstem auditory evoked response (BAER) analysis. Histological examination of tissues from infected primates revealed pathology consistent with systemic polyarterisis nodosa (PAN), an autoimmune disorder associated with sudden hearing loss. Serological analyses to include the presence of autoimmune disease markers support this diagnosis. Our findings point toward an autoimmune etiology for LASV-associated sudden-onset hearing loss.