IMMUNE-MEDIATED SENSORINEURAL HEARING LOSS: A CASE REPORT

• DOI: https://doi.org/10.22533/at.ed.1595725210115

• Palavras-chave: sensorineural hearing loss; autoimmune diseases; inner ear.

• Keywords: sensorineural hearing loss; autoimmune diseases; inner ear.

• Abstract:

  Introduction: Immune-mediated sensorineural hearing loss is a rare condition characterized by bilateral and asymmetrical hearing loss, with rapid onset and variable progression, caused by an autoimmune reaction against inner ear proteins. Its pathophysiological mechanisms are still uncertain and there are no well-defined diagnostic criteria, with antibody testing against HSP70 being the test most associated with these hearing losses. Treatment is based on corticosteroid and immunosuppressant therapy. Aims: To describe a case of a patient with right-sided immune-mediated sensorineural hearing loss. Methods: This is a descriptive, narrative and reflective case report. The participant was chosen because of the rarity of his disease and the data was obtained from an analysis of the patient's medical records. Case description: 54-year-old man complaining of reduced hearing acuity on the right and bilateral tinnitus. He also reported arthralgia and swelling in the joints of the fingers, elbows and knees, as well as a positive family history of autoimmune diseases. Audiometry and impedanciometry were suggestive of right-sided sensorineural hearing loss and rheumatology screening was positive for anti-HSP70 antibodies. The patient was referred to a rheumatologist to start immunosuppressive therapy. Discussion: Systematic studies and meta-analyses have established a strong association between autoimmune diseases and sensorineural hearing loss. The patient's clinical condition together with his family history and positivity for anti-HSP70 antibodies corroborate the suspicion that the patient's hearing loss is due to an autoimmune process. The patient was therefore correctly referred for treatment, with the aim of stabilizing the hearing loss and treating the underlying autoimmune condition. Conclusion: It is clear that the association between sensorineural hearing loss and autoimmune diseases highlights the need for a multidisciplinary approach in the management of patients with progressive hearing loss and systemic symptoms, with a view to preventing possible major functional losses resulting from the disease and significantly improving quality of life.