Anti-endothelial autoantibodies in patients with sudden hearing loss.

ObjectiveslHypothesis: Sudden hearing loss (HL) can be caused by autoimmune disorders localized to the inner ear or secondary to systemic immune dis- eases. Studies in autoimmune animal strains showing HL have reported changes in the cochlear stria vas- cularis. The authors investigated the presence of an- tiendothelial cell antibodies (AECA) to see if immune- mediated vasculitis may play a role in human sudden HL. Study Design: A prospective study in patients with sudden HL. Methods: Fifteen consecutive pa- tients (mean age, 32 y) affected by sudden HL and 14 normal subjects were included. Patients with familial deafness and metabolic diseases were excluded. Ex- tensive audiovestibular, imaging, microbiological, immunological, and routine examinations were per- formed. AECA were detected on rat kidney tissue sec- tions on the sera collected at -20°C. Results: AECA were positive in 8 of 15 patients (53%) (2 of 5 men and 6 of 10 women), thus differing significantly from the normal control population, in which only 2 of 14 tested AECA positive (P = .023). Conclusions: In pa- tients with sudden HL, immune-mediated vascular damage can have a pathogenetic role and AECA might represent a serological marker of vasculitis. Key Words: Sudden hearing loss, immune-mediated vascular damage, anti-endothelial cell antibodies.