title: High prevalence of systemic autoimmune diseases in patients with Menière's disease.
abstract: BACKGROUND
  Autoimmunity appears to be associated with the pathophysiology of Meniere's disease (MD), an inner ear disorder characterized by episodes of vertigo associated with hearing loss and tinnitus. However, the prevalence of autoimmune diseases (AD) in patients with MD has not been studied in individuals with uni or bilateral sensorineural hearing loss (SNHL).
  
  
  RESULTS
  We estimated the prevalence of AD in 690 outpatients with MD with uni or bilateral SNHL from otoneurology clinics at six tertiary referral hospitals by using clinica criteria and an immune panel (lymphocyte populations, antinuclear antibodies, C3, C4 and proinflammatory cytokines TNFα, INFγ). The observed prevalence of rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and ankylosing spondylitis (AS) was higher than expected for the general population (1.39 for RA, 0.87 for SLE and 0.70 for AS, respectively). Systemic AD were more frequently observed in patients with MD and diagnostic criteria for migraine than cases with MD and tension-type headache (p = 0.007). There were clinical differences between patients with uni or bilateral SNHL, but no differences were found in the immune profile. Multiple linear regression showed that changes in lymphocytes subpopulations were associated with hearing loss and persistence of vertigo, suggesting a role for the immune response in MD.
  
  
  CONCLUSIONS
  Despite some limitations, MD displays an elevated prevalence of systemic AD such as RA, SLE and AS. This finding, which suggests an autoimmune background in a subset of patients with MD, has important implications for the treatment of MD.
authors: Genyo, Centro de Genómica e Investigación Oncológica, Pfizer/Universidad de Granada/Junta de Andalucia, Granada, Spain.
authors: Irene
authors: I
authors: Gazquez
authors: Andres
authors: A
authors: Soto-Varela
authors: Ismael
authors: I
authors: Aran
authors: Sofia
authors: S
authors: Santos
authors: Angel
authors: A
authors: Batuecas
authors: Gabriel
authors: G
authors: Trinidad
authors: Herminio
authors: H
authors: Perez-Garrigues
authors: Carlos
authors: C
authors: Gonzalez-Oller
authors: Lourdes
authors: L
authors: Acosta
authors: Jose A
authors: JA
authors: Lopez-Escamez
mesh_terms: D000328:Adult; D001327:Autoimmune Diseases / Q000097:blood / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000097:blood / Q000150:complications; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D016014:Linear Models; D008297:Male; D008575:Meniere Disease / Q000097:blood / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology; D008875:Middle Aged; D010641:Phenotype; D015995:Prevalence; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014717:Vertigo / Q000097:blood / Q000150:complications
chemical_list: D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma