Progressive bilateral sensorineural hearing loss induced by an antithyroid drug.
We report a patient with antithyroid drug-induced progressive bilateral sensorineural hearing loss associated with myeloperoxidase-antineutrophil cytoplasmic antibodies (MPO-ANCA). While antithyroid drugs have been linked to MPO-ANCA-associated small-vessel vasculitis, sensorineural hearing loss rarely was noted. A 36-year-old man treated for hyperthyroidism with propylthiouracil (PTU) developed progressive bilateral sensorineural hearing loss accompanied by fever and arthritis. MPO-ANCA were demonstrated in serum. Distortion product otoacoustic emissions test results suggested dysfunction of outer hair cells of the organ of Corti. Inner ear blood flow impairment from ANCA-associated small-vessel vasculitis presumably caused cochlear dysfunction. PTU withdrawal and high-dose methylprednisolone administration greatly improved hearing on both sides.
Sano
Masaki
M
Department of Otorhinolaryngology and Head and Neck Surgery, Graduate School of Medicine and Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. gakutaikyo@yahoo.co.jp
Kitahara
Nobuo
N
Kunikata
Ryutarou
R
D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D013956:Antithyroid Agents / Q000009:adverse effects*; D006111:Graves Disease / Q000097:blood / Q000188:drug therapy; D006312:Hearing Loss, Bilateral / Q000097:blood / Q000139:chemically induced* / Q000201:enzymology; D006319:Hearing Loss, Sensorineural / Q000097:blood / Q000139:chemically induced* / Q000201:enzymology; D006801:Humans; D008297:Male; D009195:Peroxidase / Q000097:blood; D011441:Propylthiouracil / Q000009:adverse effects*
D019268:Antibodies, Antineutrophil Cytoplasmic; D013956:Antithyroid Agents; D011441:Propylthiouracil; D009195:Peroxidase