Autoimmune identification of sudden hearing loss.
OBJECTIVE
To identify autoantibody bands using Western blotting in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).


METHODS
All patients admitted to our emergency ward with ISSNHL during a 3-year period (n = 51) were included in a diagnostic laboratory protocol, which included a non-specific test battery for immune disorders and a Western blot (WB) for bovine cochlear antigen, and underwent corticosteroid therapy.


RESULTS
In 16 cases (31%) a band was identified in the WB. Cases with a positive WB showed abnormal results in a greater number of non-specific laboratory tests (3.6 +/- 1.3 vs 0.9 +/- 1.1; p < 0.001) and had greater hearing recovery (33.8% +/- 17.7% vs 50.6% +/- 18.5%; p < 0.01). Moreover, patients with a positive WB showed good correlations between the degree of hearing recovery and both early onset of treatment (0.5504x + 43.621; R2 = 0.8603; p < 0.01) and age (0.4053x + 56.298; R2 = 0.8952; p < 0.01). The non-specific test battery showed a sensitivity of 78% and a specificity of 94% for detecting an autoimmune disorder compared with WB.


CONCLUSIONS
A positive WB predicts a good response to corticosteroid therapy in ISSNHL patients. If it is not possible to perform a WB then the non-specific test battery has a good capability for predicting autoimmune disorders.
García Callejo
F J
FJ
Servicio de Otorrinolaringología, Hospital Clinico Universitario de Valencia, Valencia, Spain.
Marco Algarra
J
J
Martínez Beneyto
M P
MP
Orts Alborch
M H
MH
Morant Ventura
A
A
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001299:Audiometry / Q000379:methods; D001323:Autoantibodies / Q000032:analysis*; D001327:Autoimmune Diseases / Q000150:complications* / Q000175:diagnosis; D015153:Blotting, Western; D015331:Cohort Studies; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D003639:Hearing Loss, Sudden / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D012044:Regression Analysis; D012680:Sensitivity and Specificity
D000305:Adrenal Cortex Hormones; D001323:Autoantibodies