Acute Phase Reactants in Immune-Related Inner Ear Disease

Abstract

In this study, the clinical profile of patients with immune-related inner ear disease (IRIED) was correlated with the laboratory results of acute phase reactants and quantitative immunoglobulin as guide in the management of the disease. A 2-year prospective review of the patients with diagnosis of immune-related inner ear disease through the year 2004 to 2006 was carried out. IRIED accounted for 15 cases, 9 females and 6 males, the age ranging between 21 and 62, average of 45. Of this, autoimmune inner ear disease accounted for 8/15 (53%), Meniere’s disease 4/15 (27%) and vestibular hydrops 3/15 (20%). The erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and Immunoglobulin E (Ig E) were elevated in 10/15 (67 %), 6/15 (40 %), and 6/15 (40 %) respectively; while rheumatoid factor was identified in 4/15(27%).The predisposing factor was presumed to be autoimmune in 7(48%), allergy in 6(40%) and one patient had trauma in addition. Following treatment, response to therapy was observed in 10/15(67%) patients; 6/8(75%) patients with AIED, 3/4 (75%) meniere’s disease and 1/3(33%) vestibular hydrops. A high index of clinical suspicion and screening with ESR and CRP are useful guide in the management of patients, however, there is need for a simple and more specific immunodiagnostic assays.

Key Word: autoimmune inner ear disease, allergy, meniere’s disease, laboratory results