The association of the plasma vasopressin level during attacks with a prognosis of Meniere's disease

Abstract

Abstract

An elevation of the plasma arginine vasopressin (AVP) level has frequently been observed in Meniere's disease patients. However, little is known regarding the mechanism behind this elevation. The plasma AVP levels in acute phase were determined in 21 Meniere's disease patients and 16 patients with other types of vertigo. The plasma AVP levels of Meniere's disease patients in the acute phase were significantly higher than in those of other vertigo patients (p < 0.01). In Meniere's disease patients with abnormally high levels of AVP (more than 3.5 pg/ml) in the acute phase, 36% of patients were resistant to conservative treatments for frequent vertigo attacks for the follow-up period of at least 2years. A significant correlation was observed between the plasma AVP in the acute phase and the highest hearing threshold level at a frequency of 1kHz for the follow-up period of at least 1 year (r=0.45, p < 0.05). These results suggest that the elevation in plasma AVP level in the acute phase is associated with the prognosis of Meniere's disease.

Sumario

La elevación del nivel plasmático de vasopresina arginina (AVP) ha sido frecuentemente observado en los pacientes con enfermedad de Meniere. Sin embargo, se sabe poco de los mecanismos detrás de esta elevación. Se determinaron los niveles plasmáticos de AVP durante la fase aguda en 21 paciente con enfermedad de Meniere y en 16 pacientes con otro tipo de vértigo. Los niveles plasmáticos de AVP en los pacientes en la fase aguda de la enfermedad de Meniere fueron significativamente más elevados que aquellos con otro tipo de vértigo (p < 0.01). De los pacientes con enfermedad de Meniere y niveles anormalmente elevados de AVP (más de 5.5 pg/ml) durante la fase aguda, 36% de ellos fueron resistentes al tratamiento conservador para los ataques frecuentes de vértigo en un periodo de seguimiento de hasta 2 años. Se observó una correlación significativa entre el nivel plasmático de AVP en la fase aguda y el umbral más elevado en la frecuencia de 1kHz durante el periodo de seguimiento de un año (r = 0.45, p < 0.05). Estos resultados sugieren que la elevación plasmática de AVP en la fase aguda está asociada con el pronóstico de la enfermedad de Meniere.

Key Words:

• Meniere's disease
• plasma arginine vasopressin
• plasma osmolality

Acknowledgements

This study was supported by grants-in-aid for scientific research of the Japan society for the promotion of science (No. 20591978), a grant-inaid from Gifu University School of Medicine for the promotion of science, and a grant from the intractable diseases fund (vestibular disorders) of the Ministry of Health and Welfare, Japan.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.