Department of Ear, Nose and Throat, West Suffolk Hospitals NHS Trust, Bury Saint Edmunds, UK
Department of Ear, Nose and Throat, North West Anglia NHS Foundation Trust, Peterborough, UK.
BMJ Case Rep. 2022 Jul 12;15(7):e248969. doi: 10.1136/bcr-2022-248969.
We report the case of a woman in her 30s who was referred to the ear, nose and throat department with sudden onset left-sided sensorineural hearing loss (SNHL), left anterior uveitis and erythematous lower limb lesions with bilateral pitting oedema. Based on her symptoms, an underlying inflammatory systemic disease was suspected. Autoantibodies were negative but an X-ray and high-resolution CT scan of the chest were suggestive of sarcoidosis, which was confirmed on endoscopic bronchial biopsy. Following treatment with a course of oral steroids, the patient's hearing has improved but she still suffers from episodes of uveitis. While immune-mediated inner ear disorders are a recognised cause of SNHL, sarcoidosis is a very rare cause. This case demonstrates the importance of screening for systemic autoimmune aetiology in SNHL and highlights the importance of an effective multidisciplinary team in the diagnosis and management of these patients.
我们报告了一例 30 多岁女性的病例,她因突发性左侧感音神经性听力损失(SNHL)、左眼前段葡萄膜炎和红斑性下肢病变伴双侧凹陷性水肿而被转至耳鼻喉科。根据她的症状,怀疑存在潜在的炎症性全身性疾病。自身抗体检测为阴性,但 X 光和胸部高分辨率 CT 扫描提示为结节病,经支气管内镜活检得到证实。在接受一疗程口服类固醇治疗后,患者的听力有所改善,但仍会出现葡萄膜炎发作。虽然免疫介导的内耳疾病是 SNHL 的已知病因,但结节病是一种非常罕见的病因。该病例表明在 SNHL 中筛查全身性自身免疫病因的重要性,并强调了有效多学科团队在这些患者的诊断和管理中的重要性。