돌발성 난청환자에서 바이러스 IgM 항체검사의 임상적 유용성

Abstract

Background and Objectives There are many possible causes of sudden deafness such as viral infection, vascular occlusion, immune-mediated mechanism and abnormal cellular stress response in the cochlea. Viral hypothesis is one of the potential mechanisms for explaining sudden deafness. The aims of this study were to investigate the usefulness of viral IgM antibodies to evaluate the clinical findings and prognosis in sudden sensorineural hearing loss and to identify the more useful viral IgM antibodies. Subjects and Method A retrospective study was carried out for 283 patients with sudden deafness. The results of serologic tests performed for the following were studied: Ebstein barr virus (EBV), Measles, Mumps, Toxoplasma, Rubella, Cytomegalovirus, Varicella zoster virus, Herpes simplex virus, and human immunodeficiency virus. Results of blood tests and audiologic tests taken initially and 2 months after the onset of sudden deaf were studied as well. Results Positive ratio of Viral IgM antibodies was 4.9% (13/283). Clincial findings and prognosis of viral IgM positive patients were not different from other sudden deafness patients except for the age factor. EBV Viral capsid antigen, EBV Early antigen-diffuse and restrict complex were common positive viral markers in sudden hearing loss patients. One third of the patients (4/13) had viral markers for Measles, Mumps and Toxoplasma. Conclusion In sudden deafness, the positive ratio of serologic tests for viral IgM antibodies was less than 5% and viral IgM positive patients had similar clinical findings and prognosis to viral IgM negative patients. However, viral origins of Measles, toxoplasam and Mumps as well as EBV should be considered in sudden deafness patients with the symptoms and signs of viral infection.