両側メニエール病に見られる免疫現象

抄録

Patients with bilateral Meniere's disease were investigated for possible immunologic abnormalities. Thirty six cases of bilateral Meniere's disease were examined and compared with 58 cases of unilateral Meniere's disease, 37 of bilateral sensorineural hearing loss and 6 of syphilitic endolymphatic hydrops. Immune activity was assessed using four types of immune parameters:(1) serum immunoglobulin levels (IgG, IgM, and IgA);(2) erythrocyte sedimentation rate (ESR) and C-reactive protein levels (CRP);(3) complement levels (C3, C4, CHSO);(4) autoantibody levels (rheumatoid factor, anti-DNA antibody, and antinuclear antibody). Of 36 patients with bilateral Meniere's disease, 15 patients (41.6%) showed abnormalities in more than 2 parameters of 4 and are assumed to have mild immunologic abnormalities. Helper T cell (CD4) and suppressor T cell (CD8) population were examined in 19 cases out of 36 bilateral Meniere's disease and elevated CD4/CD8 ratio were found in 63.2% of 19 cases. These figures were significantly higher than that of unilateral Meniere's disease and other inner ear diseases. From these results, immunologic involvement may be assumed in about 40-60% of bilateral Meniere's disease. The possible immunologic involvement is well worth investigation in bilateral Meniere's disease.