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Abstract
BACKGROUND AND AIMS Inflammatory bowel disease (IBD) has many characteristics of autoimmune diseases. Sensorineural hearing loss has been reported in many autoimmune diseases. Little is known about hearing loss in patients with IBD. METHODS A prospective blinded comparative study was conducted over a 3-year period. IBD patients and controls underwent a complete otorhinolaryngeal examination and eudiometry test. RESULTS Altogether 105 participants (76 patients and 29 controls) took part in this study. Mean age was 36, 51 % were males, and 40 % of the patients were presently hospitalized due to IBD exacerbation. Audiometric examination revealed that any hearing loss (mild to severe) was found in 29 (38 %) of the IBD population, compared to 4 (14 %) of the control group (p = 0.02). Extraintestinal manifestation (EIM) was present in 33/76 (43 %) of IBD patients. Any hearing loss and moderate to severe hearing loss were found in 17/33 (52 %) and 7/33 (21 %) in the EIM-positive group compared to 12/43 (28 %) and 4/43 (9 %) in the EIM-negative group (p = 0.036 and p = 0.14, respectively). Out of patients over the age of 40 with other EIMs, all 11/11 (100 %) of patients had any hearing loss compared to 8/12 (66 %) of patients over the age of 40 without other EIMs, p = 0.035. CONCLUSIONS Hearing loss may be another EIM of IBD. It is found in 38 % of IBD patients and in up to 52 % of patients with other EIMs and increases over the age of 40. Early hearing evaluation should be recommended to these high-risk IBD patients.
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Kalyoncu D, Urganci N, Calis AB, Ozbal A. Sensorineural hearing loss in pediatric patients with inflammatory bowel disease. Dig Dis Sci 2010; 55:150-2. [PMID: 19255853 DOI: 10.1007/s10620-009-0714-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Accepted: 01/12/2009] [Indexed: 12/09/2022]
Abstract
OBJECTIVES Sensorineural hearing loss as an extraintestinal manifestation of inflammatory bowel disease has been reported in several studies, including adult patients. The aim of this study is to determine the presence of subclinical sensorineural hearing loss associated with inflammatory bowel disease in pediatric patients. METHODS Otoscopy, tympanometry, and pure tone audiometry were performed in 24 patients with disease and 20 healthy age- and sex-matched controls. RESULTS Pure tone audiometry did not show significant sensorineural hearing loss over all frequencies in patients with inflammatory bowel disease compared with controls (P > 0.05). CONCLUSIONS Subclinical sensorineural hearing loss was demonstrated in adult patients with inflammatory bowel disease; therefore we recommend performing audiometric examinations in pediatric patients to recognize hearing loss early during the course of the disease.
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Affiliation(s)
- Derya Kalyoncu
- Department of Pediatrics, Sisli Etfal Training and Research Hospital, 34270 Istanbul, Turkey.
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Inner-ear obliteration in ulcerative colitis patients with sensorineural hearing loss. The Journal of Laryngology & Otology 2007; 122:871-4. [DOI: 10.1017/s0022215107001351] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjective:Systemic autoimmune diseases, including ulcerative colitis, may involve the inner ear. Several ulcerative colitis cases presenting with sensorineural hearing loss have been reported. We report the T2-weighted, three-dimensional, inner-ear magnetic resonance imaging findings in the inner ears of two such patients.Methods:Case reports and a review of the literature concerning autoimmune disease and sensorineural hearing loss are presented.Results:We describe two cases of ulcerative colitis with sensorineural hearing loss in which three-dimensional magnetic resonance imaging revealed obliteration of the inner ear. Those inner ears with obliteration had severe hearing loss, and responded poorly to steroid therapy.Conclusion:To our knowledge, there has been no previous published report of the T2-weighted, inner-ear magnetic resonance imaging findings of cases of ulcerative colitis with sensorineural hearing loss. This paper represents the first published report in the world literature of inner-ear obliteration in such patients. Three-dimensional magnetic resonance imaging is beneficial in elucidating the pathophysiology of the inner-ear involvement seen in ulcerative colitis.
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Akbayir N, Caliş AB, Alkim C, Sökmen HMM, Erdem L, Ozbal A, Bölükbaş F, Akbayir N. Sensorineural hearing loss in patients with inflammatory bowel disease: a subclinical extraintestinal manifestation. Dig Dis Sci 2005; 50:1938-45. [PMID: 16187200 DOI: 10.1007/s10620-005-2964-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2004] [Accepted: 02/17/2005] [Indexed: 12/09/2022]
Abstract
Isolated case reports in which symptomatic hearing loss develops suddenly during the course of inflammatory bowel disease (IBD) have been reported, but the presence of subclinical sensorineural hearing loss (SNHL) associated with IBD has been investigated in only two preliminary studies. In order to research this further, we aimed to investigate the presence of subclinical SNHL in IBD by comparison with a control group and to examine possible relations between the bowel disease parameters and hearing loss.Otoscopy, tympanometry, and pure tone audiometry were carried out in 39 patients with IBD (21 Crohn's disease [CD], 18 ulcerative colitis [UC]) and 25 healthy age- and sex-matched controls. All patients and control subjects had normal otoscopy findings and tympanometry was unremarkable, excluding middle ear disease and conductive hearing loss. Analysis of each frequency examined showed that the average hearing thresholds were increased significantly in the study group compared to those of the control group at higher frequencies (2, 4, and 8 kHz). When these parameters were compared with the control group according to subgroups of IBD, a significant difference was determined for the UC group at frequencies of 2, 4, and 8 kHz and for the CD group only at the frequency of 4 kHz. Although there was a trend of increment in SNHL as the age of the patient and duration and extent of UC increased, no significant correlation was observed between SNHL and these parameters or sex, activity, involvement site, medication history of IBD, and coexistence of other extraintestinal manifestations. In conclusion, it was demonstrated that a subclinical SNHL may be associated with UC and somewhat with CD, affecting mainly the high frequencies. In light of this finding, it may be advisable to investigate labyrinth functions as well as other extraintestinal manifestations in patients with IBD.
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Affiliation(s)
- Nihat Akbayir
- Department of Gastroenterology, Sişli Etfal Training and Research Hospital, Istanbul.
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García Callejo FJ, Laporta Marín P, Velert Vila MM, Orts Alborch MH, de Paula Vernetta C, Marco Algarra J. Hipoacusia asociada a colitis ulcerosa. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2005; 56:68-73. [PMID: 15782645 DOI: 10.1016/s0001-6519(05)78574-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To value the eventual immunomediation in sensorineural hearing loss (SHL) on patients bearing of ulcerative colitis (UC). MATERIAL AND METHODS In a group of forty-nine cases with a mean age of 41.6+/-9.3 years old we studied the hearing loss level, the disease activity index, the peripheral blood inflammation markers and the anticochlear antibodies by mean of Western-blot technique (WB). RESULTS The 26.5% knew about their deafness, although SHL was detected in 59.1% of cases. The mean age of onset was 40.3+/-9.8 years. 48.9% showed a positive WB, always in 68-70 kDa molecular weight blots. Moreover, patients with positive WB showed more severe deafness, higher disease activity and more altered parameters, especially erythrosedimentation rate. CONCLUSIONS Audiologic and peripheral blood findings observed allow us to establish a reasonable suspicion of an autoimmune or immunomediated pathway of hearing loss on UC.
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Affiliation(s)
- F J García Callejo
- Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia.
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Nemoto H, Iguchi H, Ichikawa Y, Wakata N, Kurihara T. Ulcerative colitis presenting as sensorineural deafness, brainstem encephalopathy, and white matter lesions. Neurologist 2004; 10:165-8. [PMID: 15140276 DOI: 10.1097/01.nrl.0000126590.16002.39] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Several rare neurologic complications of ulcerative colitis have been reported. REVIEW SUMMARY We report a 69-year-old Japanese woman who developed bilateral sensorineural deafness, 2 attacks of bilateral ophthalmoplegia, and bilateral facial nerve palsy in association with ulcerative colitis. Laboratory data showed elevated cerebrospinal fluid (CSF) protein without pleocytosis, abnormal auditory brainstem evoked potentials, and multiple high signal lesions on magnetic resonance imaging of the brainstem and cerebral deep white matter. Her symptoms improved with corticosteroid therapy except for sensorineural deafness and an exacerbation of cerebral deep white matter lesions without any new clinical signs. CONCLUSION Immunologic mechanisms may have led to her central and peripheral nervous system findings in addition to her colon disorder.
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Affiliation(s)
- Hiroshi Nemoto
- Fourth Department of Internal Medicine, Toho University School of Medicine, Ohashi, Meguro-ku, Tokyo.
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Spier BJ, Wyman JB, Reichelderfer M, Schwartz DC. Acute sensorineural hearing loss as an early manifestation of indeterminate colitis. Dig Dis Sci 2004; 49:1275-9. [PMID: 15387357 DOI: 10.1023/b:ddas.0000037823.11694.ee] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Bret J Spier
- Department of Medicine, Division of Internal Medicine, University of Wisconsin Medical School, Madison, Wisconsin, USA
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Kumar BN, Smith MS, Walsh RM, Green JR. Sensorineural hearing loss in ulcerative colitis. CLINICAL OTOLARYNGOLOGY AND ALLIED SCIENCES 2000; 25:143-5. [PMID: 10816220 DOI: 10.1046/j.1365-2273.2000.00342.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Sensorineural hearing loss has been described in a small number of patients with ulcerative colitis. At present, it is not known whether this is a rare and sporadic association, or whether these reports represent an under recognised extra-intestinal manifestation of ulcerative colitis. The aim of this study was to determine the prevalence of hearing loss in patients with ulcerative colitis. Twenty patients with active ulcerative colitis (mean age 45 years) were recruited prospectively along with 20 healthy age- and sex-matched controls. Otoscopy, tympanometry and pure tone audiometry were performed. The activity of the disease was scored according to a 12-month cumulative disease activity index. No patients complained of auditory symptoms. Otoscopy and tympanometry were normal in all patients and controls. Pure tone audiometry showed significant sensorineural hearing loss over all frequencies in patients with ulcerative colitis compared with controls. This preliminary study indicates that subclinical sensorineural hearing loss is associated with ulcerative colitis. Further study is warranted to determine the nature of the relationship and its pathological basis.
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Affiliation(s)
- B N Kumar
- Department of Otolaryngology-Head and Neck Surgery, North Staffordshire Royal Infirmary, Stoke on Trent, UK
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Bachmeyer C, Leclerc-Landgraf N, Laurette F, Coutarel P, Cadranel JF, Médioni J, Dhôte R, Mougeot-Martin M. Acute autoimmune sensorineural hearing loss associated with Crohn's disease. Am J Gastroenterol 1998; 93:2565-7. [PMID: 9860428 DOI: 10.1111/j.1572-0241.1998.00720.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We report the sudden onset of bilateral hearing loss in a patient with Crohn's disease while the intestinal disease was quiescent. Antibodies directed against collagen type II were detected in the serum. Dramatic improvement of his hearing was observed under corticosteroid therapy. Diagnosis of autoimmune sensorineural hearing loss was established. This condition could be considered as an extraintestinal manifestation of Crohn's disease. Early diagnosis is mandated, as prompt and intensive treatment with corticosteroids and/or immunosuppressive drugs is effective and could prevent irreversible hearing loss.
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Affiliation(s)
- C Bachmeyer
- Department of Internal Medicine, Laennec Hospital, Creil, France
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Affiliation(s)
- W Arnold
- Department of Otorhinolaryngology, Head and Neck Surgery, Technical University of Munich, Klinikum rechts der Isar, Germany.
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Abstract
The association of sensorineural hearing loss and ulcerative colitis is well documented and it is speculated that this is autoimmune in origin. A case in a 12-year-old boy is described, that initially responded to steroid therapy, but four years later resulted in bilateral, profound sensorineural hearing loss in spite of good control of his bowel disease. Immunological tests may provide a clue as to the aetiology of suspected cases of autoimmune inner ear disease. Immediate treatment with steroids with or without immunosuppressive therapy is essential as delay may lead to irreversible hearing loss.
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Affiliation(s)
- B N Kumar
- Department of Otolaryngology, North Staffordshire Royal Infirmary, UK
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Nigam A, DasGupta AR. The possible association of pyoderma gangrenosum and progressive sensorineural deafness. J Laryngol Otol 1994; 108:671-5. [PMID: 7930918 DOI: 10.1017/s0022215100127793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Deafness is known to be associated with certain autoimmune disorders. This article describes a hitherto unreported possible association between pyoderma gangrenosum and progressive bilateral sensorineural deafness.
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Affiliation(s)
- A Nigam
- Department of Otolaryngology, Manor Hospital, Walsall
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Long-standing adverse reactions. Med J Aust 1993; 159:621. [PMID: 7901742 DOI: 10.5694/j.1326-5377.1993.tb138053.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Jacob A, Ledingham JG, Kerr AI, Ford MJ. Ulcerative colitis and giant cell arteritis associated with sensorineural deafness. J Laryngol Otol 1990; 104:889-90. [PMID: 2266315 DOI: 10.1017/s0022215100114264] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Sensorineural deafness is rarely associated with both ulcerative colitis and giant cell arteritis. A patient is described in whom acute sensorineural deafness occurred in association with episcleritis, ulcerative colitis and clinical features suggesting giant cell arteritis.
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Affiliation(s)
- A Jacob
- Eastern General Hospital, Edinburgh
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