Immunologic work-up study for inner ear disorders: looking for a rational strategy.
CONCLUSIONS
For the evaluation of a patient with suspected immune-mediated inner ear disease (IMIED), an exhaustive immunologic work-up study is not recommended if financial resources are limited. Analysis of antinuclear antibodies (ANA) and the immunophenotype of peripheral blood lymphocytes (PBL) proved to be the most useful tests in our population to support the clinical diagnosis of IMIED.


OBJECTIVE
Owing to the lack of specific serological markers for the diagnosis of IMIED, an exhaustive immunologic work-up study for patients with suspected IMIED is usually performed. The aim of this study was to estimate the use of resources and the costs involved in the routine laboratory tests used for the diagnosis of IMIED.


METHODS
This was a comparative study of two groups of patients with a high suspicion of diverse clinical forms of IMIED who were subjected to different serologic test designs. The cost of the classical immunologic work-up study used for the diagnosis of IMIED (n=125) was estimated in comparison with that of a more restricted examination, based on a recently reported high-risk profile, involving the analysis of ANA and PBL (n=57).


RESULTS
The diagnostic efficiency of the two protocols was similar. The cost of a complete immunologic work-up study was 241.77 euros and that of the limited analysis was 53.12 euros.
García-Berrocal
José Ramón
JR
Department of Otorhinolaryngology, Hospital Universitario Puerta de Hierro, Madrid, Spain. jrgarciab@yahoo.com
Trinidad
Almudena
A
Ramírez-Camacho
Rafael
R
Lobo
David
D
Verdaguer
María
M
Ibáñez
Andrés
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000032:analysis*; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000276:immunology; D007758:Ear, Inner / Q000276:immunology*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology / Q000276:immunology; D003639:Hearing Loss, Sudden / Q000175:diagnosis / Q000209:etiology / Q000276:immunology; D006801:Humans; D016130:Immunophenotyping; D007759:Labyrinth Diseases / Q000175:diagnosis / Q000209:etiology / Q000276:immunology*; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis / Q000209:etiology / Q000276:immunology; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012698:Serologic Tests
D000974:Antibodies, Antinuclear