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Antiphospholipid inner ear syndrome.

Debbie Aviva Mouadeb1, Michael J Ruckenstein

  • 1Department of Otolaryngology, University of California-Davis, Sacramento, California, USA. debbie_mouadeb@yahoo.com

The Laryngoscope
|May 4, 2005
PubMed
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Antiphospholipid antibodies may contribute to sensorineural hearing loss (SNHL) of unknown origin. This study found a significant association between these antibodies and inner ear dysfunction, suggesting microthrombus formation as a potential cause.

Area of Science:

  • Otolaryngology
  • Immunology
  • Vascular Medicine

Background:

  • Sensorineural hearing loss (SNHL) of unknown origin presents a diagnostic challenge.
  • Antiphospholipid antibodies (aPL) are known mediators of microthrombus formation.
  • A potential link between aPL and inner ear dysfunction has been hypothesized.

Purpose of the Study:

  • To investigate the association between antiphospholipid antibodies and sensorineural hearing loss (SNHL) of unknown origin.
  • To determine the prevalence of aPL in patients with progressive hearing loss and/or vertigo.

Main Methods:

  • Prospective study of 168 adult patients with progressive hearing loss and/or vertigo.
  • Comprehensive autoimmune and infectious disease screening panel, including anticardiolipin antibodies, anti-B2 glycoprotein, and lupus anticoagulant.

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  • Patients referred to the University of Pennsylvania's Division of Neurotology and Balance Center.

    • Main Results:

    • 25% (42/168) of patients had at least one elevated antiphospholipid antibody marker.
    • 20 patients had two or more positive aPL test results.
    • Of the 42 patients with positive aPL, 64% were diagnosed with Meniere disease, and the remainder with idiopathic SNHL; 57% had unilateral and 44% had bilateral hearing loss.

    Conclusions:

    • Data support the hypothesis that antiphospholipid antibodies contribute to the pathogenesis of SNHL.
    • Microthrombus formation in labyrinthine vasculature is a proposed mechanism.
    • Further basic science and clinical studies are needed to elucidate mechanisms and evaluate anticoagulation efficacy.