The Autoimmune Disease of the Inner Ear — A Case Report

Introduction: Characterized by sensorineural hearing loss, with fast progress, the autoimmune disease of the inner ear can involve symptoms such as disequilibrium, vertigo, tinnitus, and ear fullness. In 15 to 30% of the patients, there is a concomitant systemic autoimmune disease. The physical examination is mostly normal and laboratory tests may help screening for systemic immunologic dysfunction. The treatment consists in immunosuppressive therapy and, recently, intratympanic therapy has been used.

Objectives: The study aims to show the evaluation and the management of this condition in a 33-year-old woman.

Resumed report: A 33-year-old woman, diagnosed with ulcerative colitis, was referred by gastroenterologist because of vertigo, aural fullness, tinnitus, and fluctuating hearing loss, worse in the left ear, with a 6-week evolution. She correlated the symptoms with the reactivation of the ulcerative colitis. The audiometry showed bilateral mixed hearing loss, the computed tomography revealed soft tissue's density materials involving both ossicle chains and thickened tympanic membranes, and the laboratorial tests showed high levels of inflammatory proofs. An exploratory tympanotomy was made and with anatomopathological examination chronic inflammation and fibrosis in respiratory mucosa and bone tissue were found. The treatment started with 60 mg of prednisone, with progressive improvement of the clinical condition, but the removal of the corticoid and the substitution for another drug were not tolerated.

Conclusion: Autoimmune disease of the inner ear is a difficult diagnosis and often without an efficient treatment. It is essential to have a serial follow-up and a good control of the systemic disease.

Keywords: autoimmune, hearing loss, inner ear.