臨床顕微鏡的多発血管炎に伴った変動する感音難聴例

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Microscopic polyangitis (MPA) is one of the systemic vasculitis syndromes, including polyarteritis-nodosa and allergic granulomatosis angitis, which are characterized by clinical evidence of blood vessel inflammation that produces ischemic changes in various organs. Here we report a patient who showed bilateral fluctuating sensorineural hearing loss and diagnosed as having microscopic polyangitis. A 71-year-old woman visited our hospital complaining of redness on the nasal tip and alas. One week later she noticed tinnitus and hearing loss in the right ear, and then hearing of both ears fluctuated and responded well to the administration of predonisolone. She was suspected of having an autoimmune disease because she complained of numbness of fingers and erythema of the face. By close examination, she was diagnosed as having microscopic polyangitis and was given predonisolone and cyclophosphamide. Her bilateral hearing has been stable and MPO-ANCA became negative after the therapy. The sensorineural hearing loss in MPA may be caused by necrotic or inflammatory vasculitis in the inner ear. We should pay attention to the association of an autoimmune disease such as MPA in cases of fluctuating or repeated sensorineural hearing loss responding well to the administration of steroids.
耳鼻咽喉科臨床学会の論文