Voice disorder in systemic lupus erythematosus.

Milena S F C De Macedo,Manoel Da Silva Filho,Kauê M Costa

doi:10.1371/journal.pone.0175893

Abstract

Systemic lupus erythematosus (SLE) is a chronic disease characterized by progressive tissue damage. In recent decades, novel treatments have greatly extended the life span of SLE patients. This creates a high demand for identifying the overarching symptoms associated with SLE and developing therapies that improve their life quality under chronic care. We hypothesized that SLE patients would present dysphonic symptoms. Given that voice disorders can reduce life quality, identifying a potential SLE-related dysphonia could be relevant for the appraisal and management of this disease. We measured objective vocal parameters and perceived vocal quality with the GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) scale in SLE patients and compared them to matched healthy controls. SLE patients also filled a questionnaire reporting perceived vocal deficits. SLE patients had significantly lower vocal intensity and harmonics to noise ratio, as well as increased jitter and shimmer. All subjective parameters of the GRBAS scale were significantly abnormal in SLE patients. Additionally, the vast majority of SLE patients (29/36) reported at least one perceived vocal deficit, with the most prevalent deficits being vocal fatigue (19/36) and hoarseness (17/36). Self-reported voice deficits were highly correlated with altered GRBAS scores. Additionally, tissue damage scores in different organ systems correlated with dysphonic symptoms, suggesting that some features of SLE-related dysphonia are due to tissue damage. Our results show that a large fraction of SLE patients suffers from perceivable dysphonia and may benefit from voice therapy in order to improve quality of life.

Highlights

As medical research progresses many incurable diseases with a previously high degree of mortality become manageable with chronic care
We found that Systemic lupus erythematosus (SLE) patients have significant deficits in vocal quality, in both objective and subjective parameters, that correlate with measures of tissue damage
Our results show that a large fraction of SLE patients have dysphonic symptoms

Summary

Introduction

As medical research progresses many incurable diseases with a previously high degree of mortality become manageable with chronic care. A major challenge therein is the development of therapeutic schedules that preserve patient wellbeing over the extended life spans. Systemic lupus erythematosus (SLE), a chronic disease in which noxious antibodies gradually damage multiple organ systems, falls within this scope. Since the 1950s, SLE 5 year survival rates from diagnosis have increased from ~50% to ~99% [1,2].

Methods

Results

Conclusion