Bilateral progressive hearing loss and vestibular dysfunction with inner ear antibodies

Auris Nasus Larynx. 2010 Apr;37(2):223-8. doi: 10.1016/j.anl.2009.06.005. Epub 2009 Aug 25.

Abstract

Autoimmune inner ear disease (AIED) is a clinical syndrome of uncertain etiology. We present the neuro-otological findings of 2 cases of bilateral hearing loss, dizziness and the antibody profiles of the inner ears. Case 1 had bilateral progressive hearing loss, vestibular dysfunction and abnormal eye movement as the disease progressed. She had inner ear antibodies against 42 and 58kDa protein antigency on Western blot immune assay, and responded to glycocorticosteroid but not to immunosuppressant treatment. Intratympanic steroid injection temporally eliminated her symptoms. However, she developed idiopathic Cushing's syndrome and underwent labyrinthectomy. Case 2 became deaf as a teenager and experienced dizziness 10 years after becoming deaf. He reacted strongly to 68kDa protein and was a good responder to immunosuppressant with steroid. As we still lack a definitive diagnostic test for AIED, careful observation of the clinical course is critical for differential diagnosis regarding the bilateral progressive hearing loss.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / adverse effects
  • Autoantibodies / blood*
  • Autoimmune Diseases / diagnosis
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / immunology*
  • Betamethasone / administration & dosage
  • Betamethasone / adverse effects
  • Combined Modality Therapy
  • Cushing Syndrome / chemically induced
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Ear, Inner / immunology*
  • Ear, Inner / surgery
  • Female
  • Follow-Up Studies
  • Gentamicins / administration & dosage
  • Hearing Loss, Bilateral / diagnosis
  • Hearing Loss, Bilateral / drug therapy
  • Hearing Loss, Bilateral / immunology*
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects
  • Male
  • Prednisolone / administration & dosage
  • Prednisolone / adverse effects
  • Vestibular Diseases / diagnosis
  • Vestibular Diseases / drug therapy
  • Vestibular Diseases / immunology*
  • Vestibular Function Tests
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Autoantibodies
  • Gentamicins
  • Immunosuppressive Agents
  • Betamethasone
  • Prednisolone