Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2026 07 08 1561 1561 EN Afsaneh Doosti Department of Audiology, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Mohammad Ali Shabani Student Research Committee, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Zahra Jeddi Department of Audiology, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Ali Hajimohammadi Department of Audiology, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran 2026 04 27 2026 07 08 Background and Aim: Autoimmune Diseases (ADs), marked by immune system dysfunction and self-targeting immune responses, can damage the auditory system, leading to symptoms like tinnitus and sensorineural hearing loss. This study explores the prevalence, underlying mechanisms, diagnosis, and treatment of tinnitus within the context of ADs. Recent Findings: This narrative review identified relevant articles through searches of Web of Science, Science Direct, PubMed, and Google Scholar, using keywords related to both tinnitus (e.g. "Tinnitus", "Ringing") and ADs (e.g. "Autoimmune Disease", "Multiple Sclerosis", "Lupus"). This review found a significant prevalence of tinnitus across various ADs. Autoimmune inner ear disease exhibited the highest tinnitus rates (50–95.7%), followed by sarcoidosis (61%) and Susac’s syndrome (54–77%). Systemic lupus erythematosus (6.7–44.4%), Sjögren's syndrome (10.1–41.7%), and multiple sclerosis (up to 30%) also showed notable tinnitus prevalence. The main mechanisms involve vasculitis affecting inner ear vessels, immune complex accumulation, demyelination of auditory pathways, and hair cell damage from ototoxic immunosuppressants (e.g. cyclosporine). Regarding tinnitus treatment, corticosteroids (e.g. prednisone) offer potential benefit, though symptom relief is often temporary. Biologics (e.g. rituximab, adalimumab) have also been explored with varying degrees of success in specific cases. Conclusion: Due to the significant prevalence of tinnitus observed in ADs, it is recommended that relevant specialists consider incorporating hearing assessments, particularly those specific to tinnitus, into their evaluation protocols. This may facilitate earlier diagnosis and ultimately lead to more appropriate and timely management and rehabilitation strategies. https://avr.tums.ac.ir/index.php/avr/article/view/1561 https://avr.tums.ac.ir/index.php/avr/article/download/1561/688