Oz Rotem Semo, Gluth Michael, Tesher Melissa S
Pediatr Ann. 2019 Oct 1;48(10):e391-e394. doi: 10.3928/19382359-20190923-01.
Autoimmune inner ear disease (AIED) is a rare, but treatable cause of sudden sensorineural hearing loss in children. Most cases present acutely and involve both ears. The precise mechanism of hearing loss in AIED is not known. Many suspected etiologies have been proposed including infections, vascular abnormalities, and trauma. However, 70% of cases are defined as idiopathic. There are no standardized diagnostic criteria for AIED, and the diagnostic process may be challenging. Positive auto antibodies and response to immunosuppressive therapy support the diagnosis. Treatment may include corticosteroids and steroid-sparing immunosuppressive medications. A high index of suspicion is recommended as the hearing loss may be stabilized or even reversed with early treatment. Long-term medical treatment failures generally have good outcomes with cochlear implantation. [Pediatr Ann. 2019;48(10):e391-e394.].
自身免疫性内耳疾病(AIED)是儿童突发性感音神经性听力损失的一种罕见但可治疗的病因。大多数病例起病急,双耳受累。AIED导致听力损失的确切机制尚不清楚。已经提出了许多疑似病因,包括感染、血管异常和创伤。然而,70%的病例被定义为特发性。AIED没有标准化的诊断标准,诊断过程可能具有挑战性。自身抗体阳性以及对免疫抑制治疗的反应支持诊断。治疗可能包括皮质类固醇和减少类固醇用量的免疫抑制药物。建议高度怀疑,因为早期治疗听力损失可能会稳定甚至逆转。长期药物治疗失败的患者接受人工耳蜗植入通常会有良好的效果。[《儿科年鉴》。2019年;48(10):e391-e394。]