Autoimmune hearing loss and ulcerative colitis.

This is a male 23-year-old patient presenting with right tinnitus, ipsilateral hypoacusis and dizziness following three months of diarrhea and weight loss. The patient was taking deflazacort and budesonide, which improved his intestinal, hearing and postural symptoms, but not the tinnitus. Initial audiometry revealed mild right sensorineural dysacusis. Laboratory exams included a positive ANF, an increased C-reactive protein, mucoproteins and HSV. Otoneurology suggested a right peripheral vestibular deficit syndrome. Magnetic resonance imaging was normal. Colonoscopy showed colon and rectal hyperemia with erosions and ulcers, distal transverse colon and distal rectal stenosis; pathology disclosed non-specific chronic rectocolitis. The patient used medication during one month and remained clinically stable for a further three months before recurring. Audiometry revealed a right auditory decline in all frequencies, mostly for higher frequency sounds. (Figure 1) Prednisone (60 mg per day) was introduced, with clinical improvement, after which the dose was reduced to 20 mg per day. Follow-up audiometry revealed audiometric improvement, especially at 1 and 2KHz. Mild asymptomatic left dysacusis for lower frequency sounds was also observed. The patient remained with occasional right hypoacusis and constant tinnitus, although this did not interfere in his daily activities; intestinal symptoms also regressed. At present the patient is taking mesalazine and prednisone.