Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Italy.
Acta Otorhinolaryngol Ital. 2011 Dec;31(6):399-401. Epub 2011 Sep 14.
Sensorineural hearing loss of immune-mediated origin may be present as a symptom in systemic autoimmune diseases or may occur as a primary disorder without other organ involvement (auto-immune inner ear disease). The diagnosis of auto-immune inner ear disease is still predicated on clinical features and to date specific diagnostic tests are not available. We report a case of right-sided sudden hearing loss in a female patient in which the clinical manifestations, in addition to ANA positivity and hypocomplementaemia allowed us to hypothesize an auto-immune inner ear disease. The immunosuppressive treatment with cyclosporine-A was capable of a recovery of the hearing that, however, occurred progressively with normalization of the hearing function after 1 year of treatment. cyclosporine-A could be proposed as a therapeutic option in case of auto-immune inner ear disease allowing the suspension of corticosteroids that, at high dose, expose patients to potentially serious adverse events.
免疫介导的感音神经性听力损失可能作为全身性自身免疫性疾病的一个症状出现,也可能作为一种无其他器官受累的原发性疾病出现(自身免疫性内耳病)。自身免疫性内耳病的诊断仍然依赖于临床特征,迄今为止还没有特定的诊断测试。我们报告了一例女性右侧突发性听力损失患者,除了抗核抗体阳性和低补体血症外,其临床表现还使我们推测可能存在自身免疫性内耳病。环孢素 A 的免疫抑制治疗能够恢复听力,但在治疗 1 年后听力功能逐渐恢复正常。环孢素 A 可以作为自身免疫性内耳病的治疗选择,从而可以停用皮质类固醇,因为大剂量皮质类固醇会使患者面临潜在的严重不良反应。