The Hearing Loss in Wegener's Granulomatosis: Relationship Between Hearing Loss and Serum Anca

Okamura, Hiro-oki; Ohtani, Iwao; Anzai, Tomohiro

doi:10.1016/s0385-8146(12)80195-7

Cited by 12 publications

(4 citation statements)

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“…In 1992, a report clarified the link between ANCA and ear symptoms [1]. In conjunction with the spread of ANCA measurements during the late 1990s, there has been a significant increase in the number of OMAAV reports [21].…”

Section: Discussionmentioning

confidence: 99%

Propylthiouracil-induced otitis media with anti-neutrophil cytoplasmic antibody-associated vasculitis: a case report and review of the literature

et al. 2021

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Propylthiouracil (PTU)-induced otitis media with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV) is an extremely rare adverse event associated with anti-thyroid drugs and is not well recognized. A 42year-old woman with Graves' disease undergoing PTU therapy for 8 years visited our hospital because of earache and congested feeling in her left ear. Blood tests, a computed tomography scan and pure tone audiometry revealed otitis media and moderate mixed hearing impairment. Antibiotics, ear drops with antibiotics and painkillers were administered. However, her earache and hearing loss gradually got worse and symptoms of facial nerve palsy appeared. At several weeks after initiation of the treatment, a high serum level of myeloperoxidase (MPO)-ANCA, 75.6 U/mL, was revealed. After excluding other causes, she was diagnosed with OMAAV. PTU was suspected as the cause of her OMAAV and was immediately discontinued, and prednisolone was started. Hearing impairment in her left ear gradually got better and showed substantial improvement. Facial nerve palsy disappeared. Although PTU-induced OMAAV is an extremely rare disease, it is important to recognize the disease, as delayed treatment can lead to irreversible hearing loss, hypertrophic pachymeningitis, and subarachnoid hemorrhage. When patients taking anti-thyroid drugs, especially PTU, are diagnosed with refractory otitis media or hearing loss, it is possible that OMAAV might be the cause and thus serum ANCA levels should be evaluated.

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Section: Discussionmentioning

confidence: 99%

Propylthiouracil-induced otitis media with anti-neutrophil cytoplasmic antibody-associated vasculitis: a case report and review of the literature

et al. 2021

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“…Wegener's granulomatosis is assigned to a systemic autoimmune disease, since symptomatic relief is obtained on steroids and immunosuppressive drugs. Regarding a cause of sensorineural hearing loss in Wegener's granulomatosis an autoimmune inner ear disease is proposed 12 l. Okamura et al 13 ) reported a patient with Wegener's granulomatosis in whom a sensorineural hearing loss was attributed to angitis because of a positive antihuman neutrophil cytoplasm antibody test and improvement with steroid therapy. However, there has been only a report of a case which was regarded as an autoimmune reaction resulting in sensorineural hearing loss on Wegener's granulomatosis.…”

Section: Discussionmentioning

confidence: 99%

Temporal Bone Pathology in Wegener's Granulomatosis

Ohtani

Baba

Suzuki

et al. 2000

FJMS

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This study aimed to demonstrate the temporal bone histopathology of two cases of Wegener's granulomatosis in which the initial symptoms were profound hearing loss and facial nerve palsy respectively.The first case, a woman of 44, suffered profound hearing loss which was remarkably improved by steroid and cyclophosphamide treatment for a time, and which seemed to be caused by invasion from granulation tissue filled in the tympanic cavity. The second case was a 61-year-old woman presenting with the facial nerve palsy. The bony canal of the horizontal portion of the facial nerve was destroyed due to granulation tissue which filled in the tympanic cavity, and granulomatous involvement was observed in the facial nerve. Wegener's granulomatosis can involve the middle ear and/or inner ear, causing hearing loss of conductive, mixed or sensorineural type. Pathogenesis of facial nerve palsy seems to be related to Wegener's granulomatous involvement of facial nerve, because the facial nerve palsy also resolved by using steroid and cyclophosphamide.

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“…A associação de hipoacusia e níveis séricos de ANCA não foi comprovada (13) e, de forma semelhante ao caso 2, há descrição na literatura de perda auditiva em portadores de Wegener com ANCA negativo. (14) O tratamento dos pacientes com alterações auditivas deve ser iniciado precocemente.…”

Section: Discussionunclassified

Perda auditiva neurossensorial em pacientes com granulomatose de Wegener: relato de três casos e revisão de literatura

Gomides¹,

Rosário²,

Borges³

et al. 2006

Rev. Bras. Reumatol.

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A granulomatose de Wegener é uma vasculite sistêmica que acomete vasos de pequeno e médio calibres. As manifestações clássicas ocorrem no trato respiratório superior, inferior e rins, mas outros órgãos podem ser envolvidos. O sistema auditivo pode ser freqüentemente acometido nas suas várias porções (orelha externa, média e/ou interna) com manifestações diversas. A perda auditiva neurossensorial pode ser conseqüência de alterações na orelha interna e deve ser precocemente reconhecida. O tratamento rápido e efetivo pode evitar danos irreversíveis. Descrevemos três casos de granulomatose de Wegener e hipoacusia sensorial, com respostas diferentes ao tratamento. Palavras AbStRActWegener's granulomatosis is a primary systemic vasculitis that affects small and medium-sized vessels. The classical manifestations occur in the upper and lower respiratory tract and in the kidneys, but other organs may be involved. The auditory system can be frequently affect in its various portions (outer, middle and/or inner ear), showing different manifestations. Neurosensory hearing loss might be a consequence of changes in the inner ear and should be recognized early. Rapid and effective treatment may prevent irreversible damage. We report herein three cases of Wegener's granulomatosis and sensory hypoacusis, which responded differently to treatment. Keywords:Wegener's granulomatosis, hearing loss, neurosensory dysacusis. INtRODUÇÃOA granulomatose de Wegener é uma vasculite granulomatosa necrotizante que afeta predominantemente vasos de pequeno e médio calibres. As manifestações ocorrem, classicamente, no trato respiratório superior, inferior e rins. Outros órgãos como olhos, pele, sistema nervoso, musculoesquelético e trato gastrointestinal também podem ser envolvidos. (1) O acometimento otológico na granulomatose de Wegener já foi bem documentado, embora sua real prevalência permaneça desconhecida. Encontramos uma variação de 15 a 80% de manifestações auditivas em séries que avaliaram pacientes com Wegener. (2)(3)(4)(5) Diversas alterações em vários sítios do sistema auditivo são descritas e podem surgir em qualquer fase de evolução da doença. O reconhecimento precoce destes distúrbios bem como a monitorização e tratamento adequados favorecem o prognóstico destes pacientes. (4)

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The Hearing Loss in Wegener's Granulomatosis: Relationship Between Hearing Loss and Serum Anca

Cited by 12 publications

References 11 publications

Propylthiouracil-induced otitis media with anti-neutrophil cytoplasmic antibody-associated vasculitis: a case report and review of the literature

Propylthiouracil-induced otitis media with anti-neutrophil cytoplasmic antibody-associated vasculitis: a case report and review of the literature

Temporal Bone Pathology in Wegener's Granulomatosis

Perda auditiva neurossensorial em pacientes com granulomatose de Wegener: relato de três casos e revisão de literatura

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