Immunology-Rheumatology Approach to Sudden Sensorineural Hearing Loss.
BACKGROUND
Sensorineural hearing loss (SNHL) and vestibular dysfunction have been described in various autoimmune disorders and systemic vasculitides. A high prevalence of SNHL is reported to occur in established rheumatologic diseases; however, immunologic and rheumatologic disorders make up a small proportion of patients with sudden sensorineural hearing loss (SSNHL).


OBJECTIVE
This prospective study was carried out in order to determine the prevalence of rheumatologic and immunologic disorders in patients with SSNHL in Northeast Iran.


METHODS
Patients with a diagnosis of SSNHL referred to our University Hospital were enrolled in this prospective study conducted over a period of 3 years. Immunology-rheumatology evaluations were performed in all patients, including detailed history, physical exams and laboratory tests such as erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), rheumatoid factor (RF), anti neutrophil cytoplasmic antibody (PR3, c-ANCA), perinuclear anti neutrophil cytoplasmic antibody (p-ANCA), antiphospholipid antibody, anti-cyclic citrullinated peptide (ACCP), and complement proteins C3 and C4.


RESULTS
Eighty-three patients with a mean age of 42.04±16.94 years were admitted into the study. The female-to-male ratio was 47% to 53%. ANA was positive in one patient, RF in six, p-ANCA in two, ACCP in one, and antiphospholipid antibody was positive in three patients with low titers. No diagnosis of rheumatologic diseases was detected, except for one patient who was diagnosed with primary Sjögren's syndrome. Fewer than 5% all cases had specific positive immunologic tests.


CONCLUSIONS
The low frequency of immunology-rheumatology positive tests and disorders in our patients with SSNHL indicates that it is not reasonable to routinely perform all related tests for every patient. Instead, clinical evaluations should be used to decide whether or not to conduct these tests.
Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Mohsen
M
Rajati
Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Massoud
M
Saghafi
Inflammation and Inflammatory Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Houshang
H
Rafatpanah
Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Bashir
B
Rasoulian
Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Shirin
S
Irani
Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Mohammadsaleh
M
Soltankhah
D000328:Adult; D000368:Aged; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000150:complications*; D003639:Hearing Loss, Sudden / Q000150:complications; D006801:Humans; D007154:Immune System Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012216:Rheumatic Diseases / Q000453:epidemiology*
Auto antibodies; SSNHL; immunology; laboratory tests; rheumatology; sudden hearing loss.