Autoimmune inner ear disease (AIED) is a rare disease, accounting for <1% of all cases of hearing impairment or dizziness. It is characterized by sensorineural hearing loss (SNHL) or vestibular dysfunction that results from an immunemediated process. Clinical features of AIED is SNHL that progresses over weeks to month with fluctuating hearing symptoms. Because there are no diagnostic laboratory and clinical feature, response to immunosuppressive therapy were important for diagnosis of AIED. Many diseases such as sudden SNHL and Meniere disease may also mimic AIED, a broad differential must be maintained in patients suspected of having AIED. We report a case of a 46-year-old female who presented with sudden hearing loss and vertigo. We could diagnose her as AIED with systemic lupus erythematous. The symptoms were improved treated with steroids.
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Sensorineural Hearing Loss of Suspected Autoimmune Etiology: Two Cases of Cogan’s Syndrome Jungmin Ahn, Brian Kim, Kyoung Rai Cho, Young-Soo Chang Korean Journal of Otorhinolaryngology-Head and Nec.2021; 64(12): 943. CrossRef
A Case of Autoimmune Sensorineural Hearing Loss Responding to Cytotoxic Agent Yong Woo Lee, Jin Lee, Min-Beom Kim, Sun O Chang Korean Journal of Otorhinolaryngology-Head and Nec.2019; 62(8): 470. CrossRef
Herpes zoster oticus usually accompanies vestibulopathy on the ipsilateral ear. However we have encountered two herpes zoster oticus patients with bilateral vestibulopathies. Bilateral vestibulopathy was detected on the 2nd month and 19th day of herpes zoster oticus, respectively. While the contralateral vestibulopathy was detected 2 month after the ipsilateral vestibulopathy in the first patient, the vestibular function deteriorated simultaneously on the 19th day in the second patient. It seems that the bilateral vestibulopathy was caused by an autoimmune process in both cases, but the initiating event is different. The ipsilateral vestibular damage may have sensitized the immune system in the first patient resulting in sympathetic vestibulopathy. But in the second patient, the ipsilateral cochlear damage may have sensitized the immune system resulting in simultaneous bilateral vestibulopathy.
Key words: Herpes zoster oticus, Bilateral vestibulopathy, Autoimmune, Sympathetic vestibulopathy