Possible association between thyroid autoimmunity and Menière's disease

Abstract

SummaryVarious aetiopathological mechanisms have been postulated to be at the root of Menière's disease (MD), and some data suggest that there may be also an underlying autoimmune factor. In fact, Menière patients manifest certain characteristics that are typical of autoimmune involvement association of particular human leucocyte antigen haplotypes, the presence of antibodies against internal ear antigens. In this study, we evaluated the association between thyroid autoimmunity and MD in a non-selected group of patients. We recruited 50 consecutive MD patients and two groups as controls: group A, 82 healthy volunteers; and group B, 50 subjects suffering from acute unilateral peripheral vestibulopathy. All subjects were submitted to instrumental assessment of cochlear-vestibular function and analysis of thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine, anti-TSH receptor antibody (TR-Ab), anti-thyroperoxidase antibody (TPO-Ab) and antithyroglobulin antibody (Tg-Ab) in the blood. The prevalence of autoimmune thyroiditis in group B [6/50 (12%); 66·7% TPO-Ab and 33·3% Tg-Ab] was superimposable with the healthy controls [6/82 (7%); 66·7% TPO-Ab and 33·3% Tg-Ab]. In contrast, 38% of the MD patients (P = 0·0001 versus group A and group B) had significant autoantibody levels (68·4% TPO-Ab; 15·8% TPO-Ab + TR-Ab; 10·5% Tg-Ab; 5·2% TPO-Ab + Tg-Ab). Furthermore, 14% of the MD patients were hyperthyroid under l-thyroxine therapy, while no dysfunction was seen in the control groups. Overall, our data demonstrate a significant association between MD and thyroid autoimmunity, which suggests that an autoimmune factor is involved in the aetiopathogenesis of this disease. These findings suggest that it should be useful to submit MD patients to multi-disciplinary clinical investigation.

Elevated Antithyroid Peroxidase and Antinuclear Autoantibody Titers in Ménière’s Disease Patients: More than a Chance Association?

“…In this setting, thyroid gland represents a useful paradigm to be studied, given the high number of autoimmune diseases to which Hashimoto's thyroiditis has been associated [Barker, 2005]. An association between AITD and MD has been postulated for over 30 years, and was recently confirmed by our and other studies [Brenner et al, 2004;Fattori et al, 2008]. On the other hand, serum ANA-positive titers have been observed in several multisystemic, non-organ-specific diseases (systemic lupus erythematosus, rheumatoid arthritis), but an association between ANA and MD has only been described by immunohistochemical studies [Wei et al, 1992] and never in serum from MD patients.…”

“…The possible association between AITD and MD has been postulated since over 30 years, although it is still a controversial issue. At the beginning of the 1980s, Kinney [1980] and Meyerhoff [1981] excluded a relationship between thyroid dysfunction and MD [Kinney, 1980;Meyerhoff et al, 1981]; however, Evans et al [1988] showed that antithyroid microsome antibodies occurred in 17% of 150 MD patients [Evans et al, 1988] and this association was recently confirmed [Brenner et al, 2004;Fattori et al, 2008]. Interestingly, Evans et al [1988] showed 2 or more positive serum autoantibody titers in 9.3% of MD patients, the commonest being antinuclear autoantibody (23.3% of patients).…”

Experimental Hyperactivity of the Endolymphatic Sac

“…Accordingly, a comparison to other endocrine disorders caused by an autoimmune mechanism seems plausible. Recently, a possible association between thyroid autoimmunity and MD was also demonstrated [Fattori et al, 2008].…”

“…thyroid dysfunction [Brenner et al, 2004], increased microsomal thyroid antibodies [Evans et al, 1988], and a significant level of autoantibodies (overall antithyroid antibody positivity) [Fattori et al, 2008]. In a recent report a significant association between MD and autoantibody increments, e.g.…”

Ménière's Disease Treatment: A Patient-Centered Systematic Review

“…None of these candidates seems to be necessary and sufficient to cause the disease. Frequently, Ménière's disease is associated with other degenerative diseases such as multiple sclerosis [Bovo et al, 2010;Spencer et al, 2002], Alzheimer's disease, autoimmune thyroiditis [Fattori et al, 2008], hyperinsulinemia [D'Avila and Lavinsky, 2005;Kirtane et al, 1984], migraine [Ibekwe et al, 2008], and Cogan syndrome [Gasparovic et al, 2011;Haynes et al, 1980]. Different therapies were proposed, some of them effective in certain patients or for certain symptoms, but the results are generally highly heterogeneous in the treated population.…”