Giani T, Simonini G, Lunardi C, Puccetti A, De Martino M, Falcini F
Department of Paediatrics, Rheumatology Unit, University of Florence, Florence, Italy.
Clin Exp Rheumatol. 2006 May-Jun;24(3):344-6.
Autoimmune inner ear disease is a cause of sensorineural hearing loss, first described in 1979 by McCabe. The occurrence during rheumatic diseases is already documented in adults, but to our knowledge, this evidence is still lacking in children. A 13-yr-old girl affected by juvenile psoriatic arthritis, treated with etanercept, developed a bilateral and asymmetric sensorineural deafness. The patient significantly improved after steroid administration. Once ruled out the principal causes of sensorineural hearing loss, we also considered the hypothesis of an anti-TNF side effect. However, the clinical presentation, the efficacy on steroid treatment and the presence of inner ear auto-antibodies prompt us to consider autoimmune-SNHL as the most plausible diagnosis. The young age of our patient seems to suggest a genetic susceptibility to autoimmunity and supports the concept of associated autoimmune diseases.
自身免疫性内耳疾病是感音神经性听力损失的一个病因，由麦凯布于1979年首次描述。成人风湿性疾病期间的发病情况已有文献记载，但据我们所知，儿童中仍缺乏这方面的证据。一名13岁患幼年型银屑病关节炎的女孩，接受依那西普治疗后出现双侧不对称感音神经性耳聋。给予类固醇治疗后患者病情显著改善。在排除感音神经性听力损失的主要病因后，我们也考虑了抗TNF副作用的假说。然而，临床表现、类固醇治疗的疗效以及内耳自身抗体的存在促使我们将自身免疫性感音神经性听力损失视为最合理的诊断。我们患者的年轻似乎表明对自身免疫存在遗传易感性，并支持相关自身免疫性疾病的概念。
