Progressive bilateral sensorineural hearing loss probably induced by chronic cyclosporin A treatment after renal transplantation for focal glomerulosclerosis.
OBJECTIVE
The immunosuppressive agent cyclosporin A (CsA) has contributed to the success of organ and bone marrow transplantation. CsA-related neurotoxicity is a well-known occurrence. Sensorineural hearing loss (SNHL) due to initiation of CsA treatment is an extremely rare finding.


METHODS
A 32-year-old man who had undergone technically uneventful cadaveric renal transplantation for focal glomerulosclerosis when 25 years old was evaluated as the result of a 10-month history of bilateral hearing loss. The patient had been taking only CsA (150 mg twice daily) and methylprednisolone.


RESULTS
Progressive bilateral SNHL was confirmed by an audiological examination. Eight months after dose reduction of CsA, pure-tone audiometry excluded progression of hearing loss.


CONCLUSIONS
To the best of our knowledge, only rare cases of CsA-related hearing loss have been reported, and none after long-term CsA treatment. Audiological findings confirmed the cochlear origin of SNHL in our patient. The action of CsA on the blood-inner ear barrier has recently been demonstrated but the mechanism of cochlear damage is still unknown. A prospective study to determine the incidence of CsA-induced hearing loss has been instituted in our department.
Marioni
Gino
G
Department of Otolaryngology, Head and Neck Surgery, University of Padua, Padua, Italy. g_marioni@virgilio.it
Perin
Norberto
N
Tregnaghi
Alberto
A
Bellemo
Barbara
B
Staffieri
Alberto
A
de Filippis
Cosimo
C
D000158:Acoustic Impedance Tests; D000328:Adult; D001300:Audiometry, Evoked Response; D001301:Audiometry, Pure-Tone; D001302:Audiometry, Speech; D001309:Auditory Threshold / Q000187:drug effects; D003051:Cochlea / Q000187:drug effects; D016572:Cyclosporine / Q000009:adverse effects*; D005923:Glomerulosclerosis, Focal Segmental / Q000601:surgery; D006312:Hearing Loss, Bilateral / Q000139:chemically induced*; D006319:Hearing Loss, Sensorineural / Q000139:chemically induced*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000379:methods; D008297:Male
D007166:Immunosuppressive Agents; D016572:Cyclosporine