Atturo Francesca, Colangeli Roberta, Bandiera Giorgio, Barbara Maurizio, Monini Simonetta
a ENT Unit, NESMOS Department, Medicine and Psychology , Sapienza University , Rome , Italy.
Acta Otolaryngol. 2017 Aug;137(8):823-828. doi: 10.1080/00016489.2017.1286035. Epub 2017 Mar 15.
The aim of the present study was to demonstrate that the positivity of nonspecific immunological tests could be found not only in bilateral hearing loss but also in unilateral cases, either sudden or progressive.
An observational case series study included subjects suffering from unilateral or bilateral, sudden or progressive, symmetric or asymmetric sensorineural hearing loss (SNHL). All the patients underwent pure tone audiometry and the following battery of blood exams: anti-nuclear antibody (ANA), extractable nuclear antigen (ENA) antibody screening, anti-thyroperoxidase (anti-TPO), anti-thyroglobulin and anti-smooth muscle antibody (ASMA).
The positivity to nonspecific immunological test was found in nearly 70% of the study groups. ASMA and ANA were found to be present in both bilateral and unilateral cases, without statistical difference. Considering the correlation between positivity/negativity and systemic autoimmune pathologies, in the bilateral forms of hearing loss, a high incidence of thyroid pathologies has been identified, with a higher percentage of systemic autoimmune diseases in respect to the normal population.
The nonspecific autoimmune tests are worth to be performed also when SNHL is not bilateral and progressive, since an immunological mechanism could also underlie unilateral and sudden SNHL cases.
本研究的目的是证明非特异性免疫测试的阳性结果不仅可在双侧听力损失中发现，也可在单侧病例中发现，无论是突发性还是进行性的。
一项观察性病例系列研究纳入了患有单侧或双侧、突发性或进行性、对称性或非对称性感音神经性听力损失（SNHL）的受试者。所有患者均接受了纯音听力测定以及以下一系列血液检查：抗核抗体（ANA）、可提取核抗原（ENA）抗体筛查、抗甲状腺过氧化物酶（抗-TPO）、抗甲状腺球蛋白和抗平滑肌抗体（ASMA）。
在近70%的研究组中发现了非特异性免疫测试的阳性结果。在双侧和单侧病例中均发现了ASMA和ANA，无统计学差异。考虑到阳性/阴性与全身性自身免疫性疾病之间的相关性，在双侧听力损失形式中，已确定甲状腺疾病的发生率较高，与正常人群相比，全身性自身免疫性疾病的百分比更高。
当SNHL不是双侧且进行性时，非特异性自身免疫测试也值得进行，因为免疫机制也可能是单侧和突发性SNHL病例的基础。
