HLA antigens in the pathogenesis of Menière's disease.

In the Department of Otolaryngology of the London Hospital many clinical and laboratory investigations have been conducted over the past fifteen years in an attempt to unravel some of the mysteries of Menière's disease. Many of these have been directed towards diagnosis, prognosis or therapy. Some have had a bearing on the aetiology of the idiopathic disease--these were summarised by Morrison (1981), including the finding of an hereditary predisposition, of an association with migraine in a significant proportion, also familial, of a 'personality type' of patient with Menière's disease and of typical radiological changes in the skull base in the majority of sufferers. More recently Brookes (1985), writing from this department, drew attention to both the occasional finding of an association between endolymphatic hydrops and elevated levels of circulating immune complexes, and also to the immunological studies in progress in patients with Menière's disease. These latter early results were reported by Morrison (1984) and are summarised in Table I. There was a highly significant difference between the levels of circulating complement and of immune complexes in patients with Menière's disease compared with control patients. There was, however, no difference in the results of autoantibody screening nor in the levels of serum immunoglobulins between the groups.