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Immunologic Screening Test and Type II Collagen Autoimmunity in Meniere's Disease
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Ja Won Koo, Min Hyun Park, Seung Ha Oh, Tai June Yoo, Sun O Chang, Chong Sun Kim
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J Korean Bal Soc. 2005;4(1):13-16.
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 Abstract
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- Background
and Objectives :Altered immunity against one’s own tissue, especially inner ear, is in part responsible for the development of Meniere’s disease (MD). Since immunologic screening test results are usually nonspecific, even if tested for those patients suspicious of autoimmune inner ear disease, they do not seem to provide valuable information. The aim of this study is to evaluate the validity of immunologic screening laboratory tests for MD patients with type II collagen (CII) autoimmunity and to discuss the diagnostic role in this localized immunologic disease.
Materials and Method : Thirty-six patients of MD in which immunologic screening laboratory test result was available were included in this study and their clinical features were described according to the criteria of AAO-HNS(1995). They were divided into two groups, CII(+) (N=8) or CII(-) (N=28) according to the presence of anti-CII antibody determined by ELISA method as described earlier. Rheumatoid factor (RF), Fluorescent antinuclear antibody (FANA), immunoglobulin G, M and A, and complement 3 and 4 were included for immunologic screening test. Individual test and clinical features were compared between groups.
Results
: Any single test did not show significant correlation between groups. But RF, total IgG and the proportion of patients more than at least one marker are higher in CII(+) group with borderline significance.
Conclusion
: Higher positive rate of immunologic screening test may support the immunologic involvement in CII(+) group. However the role of this screening test seems to be limited in a localized disease like MD compared systemic immunologic disorder, such as rheumatoid arthritis.
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Head Position Dependency of Induced Nystagmus to Ice Water Irrigation in peripheral vestibulopathy
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Byung Yoon Choi, Ja Won Koo, Seung Ha Oh, Sun O Chang, Chong Sun Kim
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J Korean Bal Soc. 2003;2(2):175-180.
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Abstract
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- Background
s and Objectives: The direction of caloric nystagmus depends on the head position as long as vestibular function is remaining but the it does not depend on head position change in the lateral semicircular canal (SCC) plugged ear, which is attributed to thermoconvection in the lateral SCC. So determination of head position dependency using ice water test is recommended in the evaluation of peripheral vestibulopathy in which dead labyrinth is suspected. Since ice water test in prone position is frequently skipped and neglected in many vestibular laboratories, we investigated the importance and necessity of evaluating head position dependency for the candidates of ice water test and estimated the amount of head position non-dependent component in discussion.
Materials and method: From January through September 2003, 25 patients, who showed no nystagmus during warm irrigation, were included in this study. Following forty milliliter of ice water irrigation in supine & prone position, the maximum slow phase eye velocity (SPEV) and direction of nystagmus were assessed using video nystagmography system.
Result
Eleven cases showed head-position dependency and were interpreted as hypofunction of lateral SCC. Fourteen cases did not show head position dependency suggesting the absence of end organ function. However, in the latter group, 6 patients, who showed definite nystagmus to ice water irrigation in supine position, can be midinterpreted as hypofunction if ice water test in prone position is not performed.
Conclusion
Evaluation of head position dependency in ice water irrigation is an important procedure in the determination of lateral SCC function and can provide valuable information when vestibular ablative procedures are considered.
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KBS
