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Nanotech & CidpUSA offer remote consultation and management of AIED
through internet consultation.
Autoimmune Inner Ear Disease
What is AIED?
Autoimmune inner ear disease or "AIED"
consists of a syndrome of hearing loss or dizziness which is
caused by antibodies or immune cells which are attacking the
inner ear. It can be a sudden
hearing loss on one side or both ears accompanied by pain.In
the past was called Meniers disease.
The classic picture is reduction of
hearing accompanied by tinnitus (ringing, hissing, roaring)
which occurs over a few months. Variants are bilateral
attacks of hearing loss and tinnitus which resemble
, and attacks of dizziness accompanied by
abnormal blood tests for self-antibodies. About 50% of
patients with AIED have balance symptoms.
we have reversed this
disease with simple antibiotics.
As there are no specific tests for AIED, a common approach
is to look for other evidence for autoimmune involvement.
Blood tests for autoimmune
disorders include:
- Sed Rate,CRP
- ANA
- Rheumatoid Factor
- Complement C1Q
- Thyroid (TSH, anti-microsomal
antibodies)
- anti-gliadin antibodies (for
Celiac disease)
Blood tests for conditions that
resemble autoimmune disorders include:
(for Syphilis)
Lyme titer
HBA1C (for diabetes, which is
often autoimmune mediated also)
HIV (HIV is associated with
auditory neuropathy)
What Are the Symptoms of AIED?
The symptoms of AIED are sudden hearing loss in one ear
progressing rapidly to the second ear. The hearing loss can
progress over weeks or months. Patients may feel fullness in
the ear and experience vertigo. In addition, a ringing,
hissing, or roaring sound in the ear may be experienced.
Diagnosis of AIED is difficult and is often mistaken for
otitis media until the patient develops a loss in the second
ear. One diagnostic test that is promising is the Western
blot immunoassay. Meniere's
disease and AIED seem to be closely intertwined. In fact,
immune dysfunction is increasingly being recognized as one
of the factors that causes Meniere's disease. Researchers
now feel that a "significant percentage" of the people with
bilateral Meniere's disease have AIED as the underlying
cause. One study indicated that immune system dysfunction
was responsible for 16% of people with bilateral Meniere's
disease and 6% of all people with any variety of Meniere's
disease. In another study, 96% of the patients with
Meniere's disease had elevated levels of circulating immune
complexes, compared to just 20% of the controls. In yet
another study, specific immune system antibodies were
detected in 47% of people with Meniere's disease. This all
shows that a large percentage of the people with Meniere's
disease have an underlying immune system problem.
What Is the Treatment for AIED?
Most patients with AIED respond to the initial treatment
of steroids, prednisone, and methotrexate, a chemotherapy
agent. Some patients may benefit from the use of hearing
aids. If patients are unresponsive to drug therapy and
hearing loss persists, a cochlear implant maybe considered.
History
Until recently it was thought that the inner ear could
not be attacked by the immune system. Studies have shown
that the perisacular tissue surrounding the endolymphatic
sac contains the necessary components for an immunological
reaction. The inner ear is also capable of producing an
autoimmune response to sensitized cells that can enter the
cochlea through the circulatory system.
-
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Semin Arthritis Rheum. 2004
Oct;34(2):538-43. |
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Autoimmune sensorineural hearing
loss: clinical course and treatment outcome.
Loveman DM,
Department of Internal Medicine, Texas Tech
. CONCLUSIONS AND RELEVANCE: This series of
patients with ASHL suggests a more variable and
benign course with a better prognosis than
previously reported. Immunosuppressive therapy other
than steroids rarely was required, and rapid
progression to complete hearing loss was very
uncommon in this cohort.
PMID: 15505769 [PubMed - indexed for MEDLINE]
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Immune-mediated inner ear
disease: 10-year experience.
Broughton SS,
Otolaryngology, University of Texas Southwestern
Medical School, Dallas, Texas, USA.
CONCLUSIONS:
Immune-mediated inner ear disease is not a uniform
disease with simple diagnosis or treatment. The
course of the disease often results in significant
long-term disability due to hearing loss and
response to aggressive immunosuppression including
corticosteroids is poor.
PMID: 15505770 [PubMed - indexed for MEDLINE]
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Laryngoscope. 2005
May;115(5):879-83. |
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Antiphospholipid
inner ear syndrome.
Mouadeb DA,
Department of Otolaryngology, University
of California-Davis, Sacramento,
California, USA. debbie_mouadeb@yahoo.com
OBJECTIVE: This study was initiated to
clarify the possible association between
antiphospholipid antibodies, - CONCLUSIONS: These data support the
hypothesis that antiphospholipid
antibodies are involved in the pathogenesis of some forms of inner ear
dysfunction, presumably by causing microthrombus formation in the labyrinthine vasculature. Basic science
studies are required to better
understand the mechanisms by which antiphospholipid antibodies mediate
inner ear dysfunction. Clinical studies
to evaluate the efficacy of
- anticoagulation in this group of
patients are also required.
PMID: 15867658 [PubMed - indexed for
MEDLINE]
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