Bilateral sudden sensorineural hearing loss as an initial presentation of myelodysplastic syndrome

Rapidly Progressing Myelodysplastic Syndrome Initially Presenting as Acute Leukemia

Myelodysplastic syndrome (MDS) refers to a group of various stem cell disorders, characterized by dysplastic and ineffective production in one or more cell lines. In general, MDS tends to present slowly over months to years and is commonly detected with routine bloodwork by primary care physicians. Patients may be asymptomatic and depending on age, comorbidities and risk classification of MDS may not require aggressive therapy. However, MDS carries the risk of progressing to acute leukemia over time. We present a case of rapidly progressive MDS in a previously healthy middle-aged female, originally presenting and treated as acute leukemia.

Macrocytosis and sudden sensorineural hearing loss: a case report

BACKGROUND

Although other blood dyscrasias are known to cause sudden sensorineural hearing loss, macrocytosis has not previously been implicated in the absence of another causative agent.

CASE REPORT

We present a case of bilateral sequential sudden sensorineural hearing loss in a patient with significant macrocytosis (mean corpuscular volume at presentation 124 fl) secondary to alcohol-induced liver dysfunction.

CONCLUSION

A possible pathophysiological mechanism linking macrocytosis and sudden sensorineural hearing loss was identified, suggesting areas for further investigation.

Bilateral sudden sensorineural hearing loss: review

Introduction:

Unilateral and bilateral sudden sensorineural hearing loss represent different disease entities. The unilateral condition is more common and predominantly idiopathic, and up to 65 per cent of patients spontaneously recover hearing. Conversely, the bilateral condition is rare, mostly associated with serious systemic conditions, and has a higher prevalence of morbidity and mortality.

Methods:

A literature search using the PubMed database was conducted using the MeSH terms ‘sudden’, ‘bilateral’ and ‘sensorineural hearing loss’.

Results:

One hundred and three reported cases of bilateral sudden sensorineural hearing loss were identified. The condition is most often associated with toxic, autoimmune, neoplastic and vascular conditions. A younger age of onset, with a bimodal age distribution, was seen for bilateral sudden sensorineural hearing loss, compared with the unilateral condition. Patients with the bilateral condition had more profound hearing loss, with poorer recovery and a 35 per cent mortality rate. Vestibular symptoms were also less common than in the unilateral condition.

Conclusion:

The presentation of bilateral sudden onset sensorineural hearing loss is a medical emergency requiring thorough and urgent investigation to exclude life-threatening and reversible conditions.