Myeloperoxidase-antineutrophil cytoplasmic antibody-associated sensorineural hearing loss.
A 36-year-old female with hyperthyroidism that had been treated with propilthiouracil (PTU) complained of tinnitus and hearing loss in both ears. She was treated with steroid administration by an otolaryngologist; however, hearing continued to fluctuate when the steroids were tapered. Laboratory evaluation revealed a decreased complement level and elevated levels of immunoglobulin M (IgM) and myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA). With the withdrawal of PTU and high-dose methylprednisolone, she had excellent return of right-sided hearing. In recent years, there have been many reports about MPO-ANCA-associated small vessel vasculitis. Although any organ may be affected by this disease, there are no reports about MPO-ANCA-associated progressive hearing loss without any other organ involvement. The present case suggests the possibility that inner ear blood flow impairment due to ANCA-associated small vessel vasculitis induces the so-called autoimmune sensorineural hearing loss.
Maguchi
S
S
Department of Otolaryngology, Teine Keijinkai Hospital, Sapporo, Japan. smaguchi@fa2.so-net.ne.jp
Fukuda
S
S
Chida
E
E
Terayama
Y
Y
D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000502:physiology*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000276:immunology*; D006801:Humans; D009195:Peroxidase / Q000502:physiology*
D019268:Antibodies, Antineutrophil Cytoplasmic; D009195:Peroxidase