Can unilateral, progressive or sudden hearing loss be immune-mediated in origin?

Abstract

Objective: 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.

Method: 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).

Results: 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.

Conclusions: 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.

Chinese abstract

结论：当感觉神经性听力损失（SNHL）不是双侧的并具渐发性时, 非特异性自身免疫测试也是值得进行的, 因为免疫机制也可能是单侧和突发SNHL病例的导因。

目的：本研究的目的是证明非特异性免疫测试的阳性结果可以不仅发现于双侧听力损失的病例, 而且发现于单侧病例, 不管这些病例是突发的或是渐发的。

方法：观察性病例系列研究包括患有单侧或双侧, 突发或渐发性, 对称或不对称SNHL的受试者。所有患者接受纯音听力测定和以下电池血液检查：抗核抗体（ANA）、可提取核抗体（ENA筛选）、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）。

结果：在接近70%的研究组中发现了对非特异性免疫测试的阳性。 ASMA和ANA被发现存在于双侧和单侧病例, 没有统计学差异。考虑到阳性/阴性和系统性自身免疫性病变之间的相关性, 在双侧听力损失形式中, 已经鉴定出甲状腺病理上的高发生率, 相较于正常人群, 具有更高比率的系统性自身免疫疾病。

Keywords:

• Immune-mediated hearing loss
• sensorineural hearing loss
• aspecific immune tests

Disclosure statement

No financial support for the work and other financial or personal connections to the work need to be declared.