Combination Immunosuppressive Therapy in Primary Autoimmune Inner Ear Disease in Pregnancy

Area of Science:

• Otolaryngology
• Immunology
• Maternal-Fetal Medicine

Background:

• Autoimmune inner ear disease (AIED) is a rare cause of rapidly progressive sensorineural hearing loss.
• Pathophysiology involves immune cell trafficking and inflammation in the inner ear, responsive to immunosuppression.
• AIED management is complex during pregnancy, necessitating careful consideration of maternal and fetal safety.

Observation:

• A case of primary AIED in pregnancy is presented, diagnosed in a 27-year-old woman.
• The patient was HSP-70 positive and experienced significant hearing and balance recovery.
• Treatment involved a combination of steroids, oral immunomodulators, plasmapheresis, and intravenous immunoglobulin (IVIG).

Findings:

• AIED diagnosis and treatment during pregnancy present unique challenges.
• Multidisciplinary management involving otolaryngologists, immunologists, and MFM specialists is crucial.
• Successful treatment of AIED in pregnancy is achievable with a comprehensive approach.

Implications:

• This case highlights the potential for successful AIED treatment in pregnancy.
• Emphasizes the importance of early diagnosis and intervention for hearing preservation.
• Underscores the need for collaborative care models to optimize outcomes for mother and fetus.