Delayed Immunomodulatory Effect of Cow Milk-Free Diet in Ménière's Disease
Federica Di Berardino1, Diego Zanetti1
1a Audiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health , University of Milan , Milan , Italy.
Objective:
Since 1930, dietary modification has been proposed as adjunct treatment in Ménière's disease (MD) with different and controversial results. We report the case of a 42-year-old female suffering from definite MD and intermittent seasonal allergic rhino-conjunctivitis because it highlights the importance of evaluating the different combinations of defined causative elements in an atopic patient with MD.
Methods:
An immunological and audiological evaluation was performed, including pure-tone, speech, and immittance audiometry; glycerol dehydration test; bithermal caloric testing; video head impulse test; cervical vestibular evoked myogenic potentials; static posturography; and Dizziness Handicap Inventory questionnaire.
Results:
A milk-free diet was crucial to relief from MD symptoms and a cow's milk challenge test was able to evoke them but vestibukar symptoms persist.
Conclusions:
The effect of dietary modification was evident only after specific immunotherapies against other allergens. This highlights the importance of evaluating different combinations of defined causative elements in the allergic treatment of MD.
Insights
Dietary changes, particularly a milk-free diet, can alleviate Ménière
Area of Science:
- Otolaryngology
- Allergy Immunology
- Neuroscience
Background:
- Dietary modification is a controversial adjunct therapy for Ménière's disease (MD).
- Atopic patients with MD may have complex triggers for their condition.
Observation:
- A 42-year-old female with Ménière's disease and allergic rhino-conjunctivitis presented with persistent symptoms.
- Comprehensive audiological and immunological evaluations were conducted.
Findings:
- A milk-free diet provided significant relief from Ménière's disease symptoms.
- Cow's milk challenge tests could evoke symptoms, but vestibular symptoms persisted.
- Dietary modification effects were observed only after allergen-specific immunotherapy.
Implications:
- This case underscores the importance of considering specific allergens in atopic patients with Ménière's disease.
- Comprehensive evaluation of combined causative elements is crucial for effective allergic treatment in MD.
- Personalized dietary interventions, alongside immunotherapy, may be key for managing complex MD cases.
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