Autoimmune inner ear disease: steroid and cytotoxic drug therapy.

Abstract

The goal of this study was to assess the effects of immunosuppressive therapy on hearing in patients with presumed autoimmune sensorineural hearing loss (AISNHL) and a Western blot assay positive for a 68 kD inner ear antigen. To achieve this objective, we conducted a retrospective review of 39 such patients who were treated with either a steroid alone or with a steroid followed by a cytotoxic agent. Pure-tone average (PTA) at 500 Hz, 1 kHz, 2 kHz, and 3 kHz, and speech discrimination scores (SDS) were used as objective measures of outcome. At the completion of treatment, 23 of the 39 patients (59.0%) exhibited a positive response to therapy. The steroid-only responders (n = 6) tended to demonstrate a greater improvement in PTA (14.8 vs 4.5 dB), while the cytotoxic-agent responders (n = 17) had a significantly greater improvement in SDS (26.2 vs 6.9%; p < 0.01). We conclude that most patients with AISNHL benefit from immunosuppressive therapy and that cytotoxic medications appear to improve SDS, even in some patients who have not responded to corticosteroid therapy.

• Authors: J M Lasak, R T Sataloff, M Hawkshaw, T E Carey, K M Lyons, J R Spiegel
• Journal: Ear, nose, & throat journal (Ear Nose Throat J) Vol. 80 Issue 11 Pg. 808-11, 815-6, 818 passim (Nov 2001) ISSN: 0145-5613 [Print] United States
• PMID: 11816893 (Publication Type: Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Immunosuppressive Agents
• Cyclophosphamide
• Azathioprine
• Methotrexate

Topics

• Adolescent
• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Aged
• Aged, 80 and over
• Autoimmune Diseases (drug therapy, immunology)
• Azathioprine (therapeutic use)
• Case-Control Studies
• Child
• Child, Preschool
• Cyclophosphamide (therapeutic use)
• Drug Therapy, Combination
• Female
• Hearing Loss, Sensorineural (drug therapy, immunology)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Male
• Methotrexate (therapeutic use)
• Middle Aged