Immunologic and serologic testing in patients with Meniere's disease

Objective: To establish the value of immunologic and serologic testing in patients with Meniere's disease. Study Design: Prospective cohort. Setting: University-based, tertiary care balance center. Intervention: Patients with active unilateral or bilateral Meniere's disease underwent testing, including antinuclear antibodies, anti-DNA antibodies, rheumatoid factor, complement levels, anti-Sjogren syndrome A and B antibodies. sedimentation rate, antiphospholipid antibodies, Western blot for anticochlear antibodies (anti-heat shock protein 70), microhemagglutination test for Treponema pallidum, and Lyme titers. Outcome Measures: Results of laboratory tests. Results: In patients with unilateral Meniere's disease (n = 40), 27% demonstrated elevated antiphospholipid antibody titers (population norm, 6-9%). The majority of these patients manifested negative assays on the other tests listed above, In patients with bilateral Meniere's disease (n = 18), elevations in antinuclear antibody titers (38%) were the most notable finding. As part of a broader study of patients with progressive heating loss. four patients with positive syphilis titers were identified: however, none of these patients complained of vertigo. Conclusion: In general, the results of this study do not support the hypothesis that immune or infectious pathologies are involved in the pathogenesis of unilateral Meniere's disease. In particular, Lyme disease does not seem to cause labyrinthine disease. However. the potential role of the thrombogenic antiphospholipid antibodies must be further investigated. Patients with bilateral Meniere's disease may be more likely to have a systemic autoimmune process.