A 38-year-old woman presents with progressive bilateral hearing loss over 6 weeks, along with tinnitus and aural fullness. Audiometry reveals the pattern marked **A** in the diagram—bilateral rapidly progressive sensorineural hearing loss across all frequencies, with >30 dB loss at multiple frequencies. She denies sudden onset and has no history of noise exposure. Systemic examination reveals a malar rash and positive ANA. Which of the following is the most likely diagnosis?
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