Autoimmune identification of sudden hearing loss

Objective-To identify autoantibody bands using Western blotting in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Material and Methods-All patients admitted to our emergency ward with ISSNHL during a 3-year period (n = 51) were included in a diagnostic laboratory protocol, which included a non-specific test battery for immune disorders and a Western blot (WB) for bovine cochlear antigen, and underwent corticosteroid therapy. Results-In 16 cases (31%) a band was identified in the WB. Cases with a positive WB showed abnormal results in a greater number of non-specific laboratory tests (3.6 +/- 1.3 vs 0.9 +/- 1. 1; p < 0.001) and had greater hearing recovery (33.8% +/- 17.7% vs 50.6% +/- 18.5%; p < 0.01). Moreover, patients with a positive WB showed good correlations between the degree of hearing recovery and both early onset of treatment (0.5504x + 43.621; R-2 = 0.8603; p < 0.01) and age (0.4053x + 56.298; R-2 = 0.8952; p < 0.01). The non-specific test battery showed a sensitivity of 78% and a specificity of 94% for detecting an autoimmune disorder compared with WB. Conclusion-A positive WB predicts a good response to corticosteroid therapy in ISSNHL patients. If it is not possible to perform a WB then the non-specific test battery has a good capability for predicting autoimmune disorders.