title: Bilateral facial nerve palsy due to otitis media associated with myeloperoxidase-antineutrophil cytoplasmic antibody.
abstract: Otitis media (OM) is well known as a common feature of proteinase 3 antineutrophil cytoplasmic antibody (PR3-ANCA)-related Wegener granulomatosis, but is a very rare condition in myeloperoxidase ANCA (MPO-ANCA)-related vasculitis. In addition, there have been a few reports showing an association of MPO-ANCA-positive OM with cranial polyneuropathy. In this report, we describe 2 patients with bilateral facial nerve palsy due to MPO-ANCA-related OM. One patient also had bilateral trigeminal neuropathy, pachymeningitis and MPO-ANCA-related glomerulonephritis, whereas the other showed isolated bilateral facial nerve palsy with OM. In both the patients, treatment with prednisolone and immune-suppressant drugs resulted in an improvement of OM and cranial polyneuropathy. Physicians should be aware that MPO-ANCA-positive OM can cause bilateral facial nerve palsy.
authors.affiliation: Departments of Neurology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Mori
authors.forename: Ken-ichiro
authors.initials: K
authors.lastname: Hira
authors.forename: Taku
authors.initials: T
authors.lastname: Hatano
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Okuma
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Kubo
authors.forename: Kazuoki
authors.initials: K
authors.lastname: Hirano
authors.forename: Kana
authors.initials: K
authors.lastname: Ohno
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Noda
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Suzuki
authors.forename: Isao
authors.initials: I
authors.lastname: Ohsawa
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hattori
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D005158:Facial Paralysis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D009195:Peroxidase / Q000276:immunology*; D011239:Prednisolone / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D019268:Antibodies, Antineutrophil Cytoplasmic; D011239:Prednisolone; D009195:Peroxidase