Does the serological study for viral infection in autoimmune inner ear disease make sense?
Viral infections of the labyrinth have been considered a major source of auditory and vestibular system pathology. However, the involvement of virus in the development of immune reactions responsible for immunomediated inner ear disease has not been studied enough. Following viral infection, an effector immune response, humoral (B cell) and/or cytotoxic (T cell) is directed against a virus and it might cross-react with self-protein or autoantigen, evoking an autoimmune response. Since clinically it can be very difficult to establish a viral etiology for such disorders, serologic studies can be used to confirm the suspected diagnosis. Patients affected by immunomediated inner ear disease that had presented an upper respiratory tract infection underwent an immunologic workup study including microbiological study. After the application of this diagnostic protocol, only one patient, that was subsequently diagnosed with Cogan's syndrome, showed a positive serological test for viral infection. On the basis of the low efficacy of serological testing and due to the lack of evidence, we do not recommend to carry out serologic studies for viral infection.
García-Berrocal
José Ramón
JR
Servicio de Otorrinolaringología, Hospital Universitario Puerta de Hierro, Madrid, Spain. jrgarciab@yahoo.com
Ramírez-Camacho
Rafael
R
González-García
José Angel
JA
Verdaguer
José María
JM
Trinidad
Almudena
A
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000032:analysis / Q000276:immunology; D001327:Autoimmune Diseases / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D015331:Cohort Studies; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000276:immunology; D005072:Evoked Potentials, Auditory; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000209:etiology / Q000276:immunology* / Q000821:virology; D006801:Humans; D007759:Labyrinth Diseases / Q000175:diagnosis* / Q000821:virology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012698:Serologic Tests
D001323:Autoantibodies