ステロイドに反応する感音難聴の血中免疫複合体と長期観察
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概要
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1. Circulating immune complexes (IC) were quantitatively measured using Raji cell immunofluorescence assay in fifty-three cases with bilateral sensorineural hearing loss (SNHL), including forty-seven cases of SNHL of unknown origin, five cases of SNHL with positive syphilitic reaction and a case of aortitis syndrome.<BR>2. High IC value (above 4μg/ml) was found in five cases (four cases of SNHL of unknown etiology and a case of aortitis syndrome). Three out of four cases of SNHL of unknown etiology responded well to steroid (predonisolone) administration, that is hearing deteriorated by discontinuation or decreased dosage of steroid and improved by readministration or increased dosage of steroid.<BR>3. There were two cases which responded well to steroid administration irrespective of the normal IC value.<BR>4. From the relation of IC value to steroid responsiveness, it was considered that there were some differences in the mechanisms of hearing improvement between cases with higher IC values and those with nomal IC values.<BR>5. Steroid-responsive SNHL was seen only in female. The hearing loss developed in their forties. The contralateral ear of these cases in which the hearing improved only in an unilateral ear showed total deafness or was almost totally deaf.<BR>6. In immunoglobulin tests IgM was found abnormal in three cases, IgA and IgG were abnormal in two cases respectively In two cases, the blood sedimentation rate was elevated when the patient noticed the hearing deterioration.<BR>7. It was confirmed that there existed SNHL which responded to steroid hormore among cases with acute hearing deterioration. For the cases improved by steroid administration or steroid readministration on recurrent hearing deterioration, autoimmune SNHL should be suspected and further immunological examinations should be done.<BR>8. By the long-term administration of steroid to steroid-responsive SNHL, it was shown that hearing deterioration could be prevented and the hearing level before treatment could be maintained.
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