1
|
Atan D, Comba A. Evaluation of Hearing Functions in Children with Celiac Disease and the Effect of Gluten-free Diet on these Functions. Niger J Clin Pract 2024; 27:664-668. [PMID: 38842717 DOI: 10.4103/njcp.njcp_137_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/12/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE The present study aims to investigate the potential impact of celiac disease (CD) on hearing functions and assess the effect of a gluten-free diet (GFD) on this condition. MATERIALS AND METHODS The study included 55 children with CD (110 ears) and 25 healthy controls (50 ears) matched for age and gender. The CD group was divided into adherent (n = 31) and nonadherent (n = 24) to GFD. Participants underwent tympanometry and pure tone audiometry assessments covering frequencies from 500 to 4000 Hz. RESULTS Patients with CD showed significantly higher air and bone conduction hearing averages compared to the control group at frequencies of 500, 1000, 2000, and 4000 Hz for air conduction, and at 500 Hz for bone conduction (P < 0.05). Celiac patients, those who fully adhered to GFD, had notably higher air conduction hearing averages at 500, 2000, and 4000 Hz compared to healthy controls (P < 0.05). However, there was no difference in bone conduction hearing averages between the two groups. In contrast, celiac patients who did not comply with GFD had statistically significantly higher air and bone conduction hearing averages than the control group (P < 0.05), at frequencies of 500, 1000, and 4000 Hz for air conduction, and at 500 and 1000 Hz for bone conduction (P < 0.05). CONCLUSIONS The study suggests that nonadherence to GFD may elevate the risk of hearing loss in children with CD. As a result, it is recommended to conduct hearing screenings for children with CD and underscore the importance of complying with GFD to mitigate further detrimental effects on hearing functions.
Collapse
Affiliation(s)
- D Atan
- Department of Otolaryngology Head and Neck Surgery, Lokman Hekim University Faculty of Medicine, Ankara, Turkey
| | - A Comba
- Departments Pediatric Gastroenterology, Hepatology and Nutrition, Hitit University Faculty of Medicine, Çorum, Turkey
| |
Collapse
|
2
|
Parabakan Polat A, Erbek HS. Evaluation of Auditory Functions in Patients with Psoriasis. Indian J Otolaryngol Head Neck Surg 2023; 75:1386-1393. [PMID: 37636806 PMCID: PMC10447668 DOI: 10.1007/s12070-023-03564-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/02/2023] [Indexed: 02/16/2023] Open
Abstract
Our study aims to evaluate the functions of the middle and inner ear and the efferent auditory system in psoriasis. Hearing thresholds, resonance frequency, otoacoustic emission amplitudes with and without contralateral acoustic stimulation, contralateral suppression levels were evaluated in 35 psoriasis patients and 40 controls. The air-conduction hearing thresholds of the patients were significantly higher than the controls at 125, 250, 500, 1000, 2000, 4000, and 12,000 Hz frequencies in the left ear, and 125, 250, 500, 1000, 2000, and 4000 Hz frequencies in the right ear, and the bone-conduction hearing thresholds of the patients were found to be significantly higher than the controls at all frequencies in the left ear, and 250, 500, 1000 and 2000 Hz in the right ear (p < 0.05). The resonance frequencies of patients were found to be significantly lower than the controls (p < 0.001). The emission amplitudes obtained with contralateral acoustic stimulation were significantly lower than without contralateral acoustic stimulation at 1 kHz frequency in both groups (p < 0.01). There was no significant difference in contralateral suppression levels of the two groups (p > 0.05). Our findings indicate that middle ear mechanics can be affected by psoriasis. There was no significant difference between psoriasis patients and healthy controls in terms of efferent auditory functions. There was a significant difference at limited frequency in hearing thresholds and emission amplitudes between the groups.
Collapse
Affiliation(s)
- Anı Parabakan Polat
- Department of Audiology, Gulhane Faculty of Health Sciences, University of Health Sciences, Emrah Neighborhood, Etlik, Keçiören, 06018 Ankara, Turkey
| | - Hatice Seyra Erbek
- Otolaryngology Head and Neck Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey
| |
Collapse
|
3
|
Ayvaz HH, Sivrice ME, Atay E. Reply to Correspondence. J Cosmet Dermatol 2022; 21:7222-7223. [PMID: 36070229 DOI: 10.1111/jocd.15364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/01/2022] [Indexed: 02/04/2023]
Affiliation(s)
- Havva Hilal Ayvaz
- Dermatology Department, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Mehmet Emre Sivrice
- Otorhinolaryngology Department, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Emrah Atay
- Public Health Expertise, Eskişehir Provincial Health Directorate, Eskişehir, Turkey
| |
Collapse
|
4
|
Ayvaz HH, Sivrice ME, Atay E. Assessment of hearing loss in patients with rosacea. J Cosmet Dermatol 2022; 21:6027-6033. [PMID: 35575907 DOI: 10.1111/jocd.15089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/10/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVES/AIMS Rosacea is not only a skin condition but a systemic inflammatory disease that includes chronic inflammation, vascular alterations, and autoimmunity in pathogenesis. We aimed to evaluate the presence of a sensorineural hearing loss in the patients with rosacea in comparison with the healthy control group and, also to compare the audiometric results according to the severity of disease among the patient group. METHODS Fifty-three patients with erythematelangiectatic or papulopustular type of rosacea and 105 age- and sex-matched healthy controls were included. Each participant had audiometric measurements after a complete ear-nose-throat examination by the same otorhinolaryngologist. RESULTS The results of air and bone conduction thresholds showed statistically significant differences in particularly high frequencies between the groups in both the right and left ear (for all p < 0.05), but there was no correlation between audiometric measurements and the severity or the type of rosacea (p > 0.05). CONCLUSIONS Regardless of disease severity or type, rosacea patients are likely to have sensorineural hearing loss, and it is important to refer these patients in the early period.
Collapse
Affiliation(s)
- Havva Hilal Ayvaz
- Department of Dermatology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Mehmet Emre Sivrice
- Department of Otorhinolaryngology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Emrah Atay
- Public Health Expertise, Eskişehir Provincial Health Directorate, Eskişehir, Turkey
| |
Collapse
|
5
|
Bodh V, Kumar R, Sharma R, Sharma B, Sachdeva A, Azad R. Sensorineural hearing loss and ulcerative colitis in remission. Indian J Gastroenterol 2022; 41:143-148. [PMID: 35247189 DOI: 10.1007/s12664-021-01216-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/19/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Sensorineural hearing loss (SNHL) has been reported in association with inflammatory bowel disease (IBD). However, SNHL as an extraintestinal manifestation of IBD is frequently underreported. In the present study, we compared the prevalence and severity of SNHL among patients with IBD-ulcerative colitis (IBD-UC) in remission with controls to find out any association between SNHL and IBD-UC in remission compared to controls. METHODS This single-center hospital-based prospective observational study included outdoor patients with IBD-UC in remission and healthy age- and sex-matched controls. Eligible patients and healthy participants were subjected to a battery of audiological tests (otoscopy, tympanometry and pure tone audiometry [PTN]) after thorough systemic and ear, nose and throat (ENT) examination. RESULTS A total of 100 patients were enrolled in the study: 50 in IBD-UC in the remission group and 50 in the control group. None of the demographic variables (age, gender, residence and habits) were significantly different between the two groups. Otoscopy and tympanometry were normal in all patients and controls. The difference between the two groups in respect to frequency and severity of SNHL on PTA and in respect to unilateral and bilateral distribution of the hearing loss was not statistically significant. CONCLUSION There is no statistically significant difference in frequency and severity of SNHL between patients with ulcerative colitis in remission and healthy age- and sex-matched controls.
Collapse
Affiliation(s)
- Vishal Bodh
- Department of Gastroenterology, Indira Gandhi Medical College, Shimla, 171 001, India
| | - Rajesh Kumar
- Department of Gastroenterology, Indira Gandhi Medical College, Shimla, 171 001, India
| | - Rajesh Sharma
- Department of Gastroenterology, Indira Gandhi Medical College, Shimla, 171 001, India
| | - Brij Sharma
- Department of Gastroenterology, Indira Gandhi Medical College, Shimla, 171 001, India.
| | - Amit Sachdeva
- Department of Community Medicine, Indira Gandhi Medical College, Shimla, 171 001, India
| | - Ramesh Azad
- Department of Otolaryngorhinology, Indira Gandhi Medical College, Shimla, 171 001, India
| |
Collapse
|
6
|
Allen P. Beethoven's triad: Diarrhoea, deafness and cirrhosis. A plausible solution to the 195-year-old controversy. Ann Diagn Pathol 2022; 58:151904. [DOI: 10.1016/j.anndiagpath.2022.151904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 01/21/2022] [Indexed: 11/01/2022]
|
7
|
Ferro JM, Oliveira Santos M. Neurology of inflammatory bowel disease. J Neurol Sci 2021; 424:117426. [PMID: 33810878 DOI: 10.1016/j.jns.2021.117426] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/21/2020] [Accepted: 03/24/2021] [Indexed: 02/07/2023]
Abstract
Inflammatory bowel diseases (IBD) are chronic inflammatory conditions affecting the digestive system, comprising two main distinctive entities, ulcerative colitis (UC) and Crohn's disease (CD). Besides gastrointestinal manifestations, IBD causes extraintestinal manifestations in the central and peripheral nervous system. The incidence of neurological complications in IBD ranges from 0.25% to 47.5%. The pathophysiology of neurological manifestations of IBD is mostly immune mediated, but dysfunction of the brain-gut axis, arterial and venous thromboembolism, infections, nutritional deficiencies and side-effects of medications (steroids, metronidazole, sulfasalazine, anti-TNF-α, anti-integrin antibodies) are other contributory mechanisms. Patients with IBD have an increased risk of arterial and venous stroke, mainly during periods of exacerbations. Vasculitis is extremely rare. There is a bidirectional association between multiple sclerosis and IBD, with a relative risk for comorbidity of 1.54, being 1.53 for the risk of multiple sclerosis in IBD and 1.55 for the risk of IBD in multiple sclerosis patients. Anti-TNF-α therapy is contraindicated in the treatment of patients who have both IBD and multiple sclerosis. Demyelinating disorders can also be a rare complication of anti-TNF-α therapy. Optic neuritis, transverse myelitis, progressive myelopathy, central nervous system infections, epilepsy and encephalopathy are among other uncommon neurological complications. Peripheral nervous system manifestations include peripheral neuropathy, either demyelination and axonal, myasthenia gravis and polymyositis/dermatomyositis and localized forms of myositis.
Collapse
Affiliation(s)
- José M Ferro
- Serviço de Neurologia, Department of Neurological Sciences and Mental Health, Hospital de Santa Maria - CHULN, Lisboa, Portugal; Faculdade de Medicina, Universidade de Lisboa, Portugal; Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal.
| | - Miguel Oliveira Santos
- Serviço de Neurologia, Department of Neurological Sciences and Mental Health, Hospital de Santa Maria - CHULN, Lisboa, Portugal; Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal
| |
Collapse
|
8
|
Polat E, Çınar Z, Keskindemirci G, Yiğit Ö, Kutluk G, Türe M, Akça T, Alkaya E. Assessment of Hearing Function in Children with Inflammatory Bowel Disease. J Int Adv Otol 2020; 16:362-366. [PMID: 33136017 DOI: 10.5152/iao.2020.6035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Inflammatory bowel disease (IBD), a chronic pathology that affects many organ systems, appears after dysregulated immune response in genetically predisposed patients. Inner organ involvement has been shown in various autoimmune diseases because of its immunosensitivity. In this study, we aimed at showing sensorineural hearing loss (SNHL) as a result of possible subclinical inflammation in patients with IBD during the remission period. MATERIALS AND METHODS We included 32 children with IBD and 31 healthy volunteers with comparable sex and age. Detailed ear-nose-throat examination was conducted for all, and patients were excluded if they had a history of ear infectionor trauma. Thereafter, the results of pure tone audiometry (PTA), high-frequency audiometry, and distortion product otoacoustic emissions testing were compared between the groups. RESULTS There were no differences in terms of age, sex, and PTA values between controls and children with IBD. No statistical differences were found between responses at 250; 500; 2,000; 4,000; DP1000; DP1400; DP2000; DP2800;and DP4000 Hz as well as the signal-to-noise ratio (SNR) at 1,000 Hz when the controls and children with IBD (p>0.05 for all) were compared. However, the mean responses at 1,000; 8,000; 10,000; 12,500; 16,000; SNR1400; SNR2000; SNR2800; and SNR4000Hz of the children with IBD were significantly higher than those of the controls (p<0.05 for all). CONCLUSION Initial SNHL appears at high frequencies in pediatric patients with IBD.
Collapse
Affiliation(s)
- Esra Polat
- Department of Pediatric Gastroenterology, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul , Turkey
| | - Zehra Çınar
- Department of Otolaryngology, University of Health Sciences İstanbul Training and Research Hospital, Istanbul, Turkey
| | - Gonca Keskindemirci
- Department of Social Pediatrics, Istanbul University Institute of Health Sciences, Institute of Child Health, Istanbul, Turkey
| | - Özgür Yiğit
- Department of Otolaryngology, University of Health Sciences İstanbul Training and Research Hospital, Istanbul, Turkey
| | - Günsel Kutluk
- Department of Pediatric Gastroenterology, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul , Turkey
| | - Muhammet Türe
- Department of Otolaryngology, University of Health Sciences İstanbul Training and Research Hospital, Istanbul, Turkey
| | - Tuğberk Akça
- Department of Pediatric Clinics, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Esat Alkaya
- Department of Otolaryngology, University of Health Sciences İstanbul Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
9
|
Abstract
There is a growing interest in the extraintestinal manifestations of common pediatric gastrointestinal diseases, such as inflammatory bowel disease and celiac disease. This article specifically focuses on the neurological symptoms that manifest because of these disorders and their treatments. Many neurological symptoms have been reported in association with these diseases, including neuropathy, myopathy, ataxia, headache, and seizures, among others. It is currently believed that these neurological symptoms are largely overlooked by practitioners and could be a red flag for earlier diagnosis. However, additional research, especially in the pediatric population, is warranted to further elaborate on the causality and pathophysiology of these neurological symptoms.
Collapse
Affiliation(s)
- Melissa Shapiro
- From the Section of Gastroenterology, Department of Pediatrics, Drexel University College of Medicine, St. Christopher's Hospital for Children, Philadelphia, PA
| | - David A Blanco
- From the Section of Gastroenterology, Department of Pediatrics, Drexel University College of Medicine, St. Christopher's Hospital for Children, Philadelphia, PA.
| |
Collapse
|
10
|
Kirito Y, Yamamoto D, Uchiyama T. Proteinase 3-antineutrophil cytoplasmic antibody-positive ulcerative colitis presenting with abducens neuropathy. BMJ Case Rep 2017; 2017:bcr-2016-218353. [PMID: 28069788 PMCID: PMC5256449 DOI: 10.1136/bcr-2016-218353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
A 72-year-old man with ulcerative colitis (UC) presented with complete left abducens nerve palsy. Although MRI showed no significant changes, cerebrospinal fluid analysis revealed pleocytosis and elevated protein and interleukin (IL)-6 levels. His serum proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA) level was also elevated to 31.1 U/mL, but granulomatosis with polyangiitis was not observed. On the basis of the diagnosis of autoimmune cranial neuropathy, he was treated with steroid therapy. While tapering steroid therapy, his serum PR3-ANCA levels; cerebrospinal fluid findings, including IL-6 levels; and symptoms improved. Serum PR3-ANCA could be a useful parameter of neurological disorders associated with ANCA-positive UC.
Collapse
Affiliation(s)
- Yuki Kirito
- Department of Neurology, Seirei Hamamatu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Daisuke Yamamoto
- Department of Neurology, Seirei Hamamatu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Tsuyoshi Uchiyama
- Department of Neurology, Seirei Hamamatu General Hospital, Hamamatsu, Shizuoka, Japan
| |
Collapse
|
11
|
Symptomatic sensorineural hearing loss in patients with ulcerative colitis. Tech Coloproctol 2015; 19:729-31. [PMID: 26280882 DOI: 10.1007/s10151-015-1349-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 05/15/2015] [Indexed: 10/23/2022]
|
12
|
Yazici S, Benbir G, Ince B. Sensorineural hearing loss and status epilepticus associated with ulcerative colitis: Is there enough evidence to support immune-related mechanisms? J Neurosci Rural Pract 2015; 6:77-9. [PMID: 25552855 PMCID: PMC4244793 DOI: 10.4103/0976-3147.143205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Ulcerative colitis (UC) is characterized by an inflammatory disorder of the gastrointestinal tract. Immune-mediated extraintestinal manifestations of UC have increasingly attracted attention in the literature recently, for which UC is now considered as a systemic disease. Neurologic involvement associated with UC is probably under-reported because of the unawareness of many physicians, although early recognition and treatment are crucial in preventing major morbidity and sequel. In this case report is presented a patient newly diagnosed as UC, who developed both sensorineural hearing loss and intractable status epilepticus that we suggest to have resulted from immune-mediated mechanisms.
Collapse
Affiliation(s)
- Sinem Yazici
- Department of Neurology, Istanbul University, Istanbul, Turkey
| | - Gulcin Benbir
- Department of Neurology, Istanbul University, Istanbul, Turkey
| | - Birsen Ince
- Department of Neurology, Istanbul University, Istanbul, Turkey
| |
Collapse
|
13
|
Urganci N, Kalyoncu D, Calis AB. Sensorineural hearing loss in pediatric patients with celiac disease. Eur Arch Otorhinolaryngol 2014; 272:2149-51. [DOI: 10.1007/s00405-014-3079-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 04/26/2014] [Indexed: 01/12/2023]
|
14
|
Abstract
Inflammatory bowel diseases (IBD) are chronic, relapsing and remitting inflammatory conditions affecting the digestive system, comprising two main distinctive diseases, ulcerative colitis (UC) and Crohn's disease (CD). Besides the classic gastrointestinal manifestations, a variable number of IBD patients present with extraintestinal manifestations, including central and peripheral nervous system involvement. Peripheral neuropathy is one of the most common complications. An inflammatory myopathy has also been found. Cranial neuropathies include the Melkersson-Rosenthal syndrome, optic neuritis, and sensorineural hearing loss. Patients with IBD have a remarkable thromboembolic tendency and are at increased risk of both venous and arterial thrombotic complications. The prothrombotic state in IBD has multiple contributors. Ischemic stroke occurs through several mechanisms, including large artery disease, small vessel disease, paradoxical embolism, endocarditis, vasculitis, and associated with anti-TNF-α therapy. Thrombosis of the dural sinus and cerebral veins are at least as frequent as arterial stroke in IBD. Multiple sclerosis has been repeatedly associated with IBD. Up to 50% of IBD present asymptomatic white matter lesions. Other central nervous system complications include a slowly progressive myelopathy, epidural and subdural spinal empyema secondary to fistulous extension from the rectum, seizures, and encephalopathy.
Collapse
|
15
|
Abstract
Labyrinthitis with vestibulocochlear dysfunction in chronic inflammatory bowl disease is a rare but well described manifestation or complication. The diagnostic and therapeutic possibilities and limitations of this inflammatory otopathy are presented and discussed in the context of a case report. A bilateral loss of vestibular function and sensorineural hearing loss occurred in a 26-year-old male patient with previously diagnosed Crohn's disease. He was treated with immune suppressive therapy during the onset and development of cochleovestibular symptoms. Diagnostic tests included pure tone audiograms, speech audiometry, caloric tests, VEMPs, and MRI. Therapy included azathioprine, corticosteroids (systemic and intratympanic), monoclonal antibodies, and cochlear implants. Despite immunosuppressive therapy including monoclonal antibodies, the patient progressively lost his hearing. Finally, bilateral cochlear implantation was carried out with good results. The treatment of patients with systemic inflammatory or autoimmune disease affecting the cochlear-vestibular organ is challenging. An interdisciplinary approach is needed. In cases of bilateral deafness, cochlear implantation is a satisfactory treatment and should not be delayed unnecessarily.
Collapse
|
16
|
Abstract
In recent years, there has been increasing recognition of the presence of gastrointestinal (GI) dysfunction in the setting of neurologic diseases. Parkinson's disease is a particularly well-known example, but GI dysfunction also may occur in multiple sclerosis, stroke, and in various myopathic and peripheral neuropathic processes. There is much less awareness, however, that primary GI diseases may also display neurologic dysfunction as part of their clinical picture. This article focuses on some of those disease processes. Illnesses primarily targeting the GI tract are addressed and examples of primary esophageal, gastric, and intestinal disease processes are described.
Collapse
Affiliation(s)
- Ronald F Pfeiffer
- Department of Neurology, University of Tennessee Health Science Center, 855 Monroe Avenue, Memphis, TN 38163, USA.
| |
Collapse
|
17
|
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.
Collapse
Affiliation(s)
- Derya Kalyoncu
- Department of Pediatrics, Sisli Etfal Training and Research Hospital, 34270 Istanbul, Turkey.
| | | | | | | |
Collapse
|
18
|
|
19
|
Palmer AR, Rosen S. British Society of Audiology Short Papers Meeting on Experimental Studies of Hearing and Deafness. Int J Audiol 2009. [DOI: 10.3109/14992020209078336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
20
|
Karmody CS, Valdez TA, Desai U, Blevins NH. Sensorineural hearing loss in patients with inflammatory bowel disease. Am J Otolaryngol 2009; 30:166-70. [PMID: 19410121 DOI: 10.1016/j.amjoto.2008.04.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2007] [Revised: 04/11/2008] [Accepted: 04/17/2008] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The study aimed to discuss the association between sensorineural hearing loss (SNHL) and inflammatory bowel disease (IBD). METHODS We reviewed cases of patients with known IBD seen in an otolaryngology practice with documentation of all otologic data including age of onset, family history of otologic problems, exposure to noise, audiometric findings, and so on. RESULTS Of 38 patients with a history of IBD, 22 had documented SNHL. Nineteen of these had no other identifiable etiology for their inner ear dysfunction. Fourteen of these patients had a diagnosis of ulcerative colitis and 5 had Crohn disease. Sixteen patients had bilateral SNHL, and 3 patients had unilateral SNHL. Only one patient had a lasting response of SNHL to medical treatment. CONCLUSION This review suggests that SNHL is an extraintestinal association of IBD. As IBD is considered to be a local or systemic immunopathy, the associated SNHL might also be an expression of systemic immune dysfunction.
Collapse
Affiliation(s)
- Collin S Karmody
- Department of Otolaryngology, Head and Neck Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA.
| | | | | | | |
Collapse
|
21
|
Abstract
Ulcerative colitis (UC) has traditionally been considered to be an inflammatory disease limited to the colonic mucosa. However, since it has been shown that UC is frequently accompanied by various extraintestinal disorders, there is increasing evidence that UC may also manifest in the nervous system. The following review focuses particularly on these possible manifestations of UC, both in the peripheral (PNS), and in the central nervous system (CNS). A systematic literature search according to the MEDLINE database was performed for this purpose. Although a reliable differentiation may clinically not always be possible, three major pathogenic entities can be differentiated: (i) cerebrovascular disease as a consequence of thrombosis and thromboembolism; (ii) systemic and cerebral vasculitis; (iii) probably immune mediated neuropathy and cerebral demyelination. With the exception of thromboembolism and sensorineural hearing loss, evidence for a causal relationship relies merely on single case reports or retrospective case series. Considering the CNS-manifestations, similarities between UC-associated disorders of the white matter and acute disseminated encephalomyelitis (ADEM) are obvious. Epileptic seizures, unspecified encephalopathies and confusional states are most likely epiphenomena that have to be regarded symptomatic rather than as own entities. A prospective study on the neurologic aspects of UC would be very welcome.
Collapse
Affiliation(s)
- R Scheid
- Day Clinic of Cognitive Neurology, University of Leipzig, Leipzig, Germany.
| | | |
Collapse
|
22
|
García Callejo FJ, Corts J, de Paula Vernetta C, Laporta P, Ramírez Sabio J, Marco Algarra J. Estudio de comorbilidad de la hipoacusia neurosensorial y otras enfermedades de patogenia autoinmune. Utilidad de las pruebas de laboratorio. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2006; 57:28-33. [PMID: 16503030 DOI: 10.1016/s0001-6519(06)78659-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To value if the sensorineural hearing loss (SHL) in several autoimmune diseases (AD) is also secondary to immunomediation. PATIENTS AND METHODS In 342 cases with SHL and any AD and 301 normoacoustic controls with AD a non-specific immunologic battery of tests and a Western-blot (WB) for anticochlear autoantibodies were developed, and cases with SHL were treated with deflazacort. RESULTS Alterations in non-specific battery were similar between cases and controls. But a 12,5% of cases with SHL and a 1,6% of normoacoustic showed a positive WB (p<0,001). Steroid therapy improved hearing in 14,3% of cases. In them, sensitivity and specificity of non-specific battery were 78,4% and 75,5%, respectively, to predict response to therapy. These were 98,9% and 81,6% for WB. CONCLUSIONS The SHL in cases with AD can be considered immunomediated in a discrete average, but the diagnostic efficiency of WB to predict an improvement after steroid therapy is high.
Collapse
Affiliation(s)
- F J García Callejo
- Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia.
| | | | | | | | | | | |
Collapse
|
23
|
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.
Collapse
Affiliation(s)
- Nihat Akbayir
- Department of Gastroenterology, Sişli Etfal Training and Research Hospital, Istanbul.
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Abstract
OBJECTIVE To analyze and discuss the deafness of Ludwig van Beethoven (1770-1827) and to offer a logical theory for its etiology. METHOD The study will carefully review the composer's symptoms as described in his letters to friends and acquaintances and also will review a large body of source material, particularly publications by his contemporaries, some of which were generously loaned by Beethoven-Haus, Bonn, Germany, where necessary translations were made directly from the original German. We will also study publications on Inflammatory Bowel Disease (IBD) and its associated extraintestinal manifestations and personal discussions with experienced gastroenterologists. RESULTS Beethoven's abdominal symptoms that began in his teens are highly suggestive of IBD, which we believe to be a correct diagnosis. IBD is an umbrella term that includes a number of named entities such as ulcerative colitis and Crohn's Disease. IBD is now considered to be a problem of immune regulation with extra intestinal manifestations that include sensorineural hearing loss and primary sclerosing cholangitis (PSC). PSC eventually causes cirrhosis and failure of the liver. A diagnosis of IBD therefore provides a single entity that explains most of the composer's symptoms and was finally the cause of his death. Our conclusion is that Beethoven's sensorineural hearing loss was an immunopathy associated with IBD.
Collapse
Affiliation(s)
- Collin S Karmody
- Department of Otolaryngology, Tufts University School of Medicine, Boston, Massachusetts, USA.
| | | |
Collapse
|
25
|
Pfeiffer RF. NEUROLOGICAL DYSFUNCTION IN GASTROINTESTINAL DISEASES. Continuum (Minneap Minn) 2005. [DOI: 10.1212/01.con.0000293720.86238.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
26
|
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.
Collapse
Affiliation(s)
- F J García Callejo
- Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia.
| | | | | | | | | | | |
Collapse
|
27
|
Abstract
Autoimmune sensorineural hearing loss has been increasingly recognized as a clinical entity since its description by McCabe in 1979. Recognition and proper management of this condition is important, as it is one of the very few forms of sensorineural hearing loss that can be successfully treated by medical therapy. Recent studies have provided experimental evidence to suggest that immune processes can cause sensorineural hearing loss in animals and humans. However, antigenic targets within the inner ear are diverse and as a result conclusive evidence for specific autoimmune damage to the inner ear has been elusive. This review focuses on the recent progress in understanding of the aetio-pathogenesis of autoimmune hearing loss along with a description of the various clinical conditions in which they occur. Recent advances in the laboratory diagnosis and management of this interesting condition are also described.
Collapse
Affiliation(s)
- J Mathews
- Department of Otolaryngology, Royal Liverpool University Hospital, Wigan, UK.
| | | |
Collapse
|