Immunologic abnormality in Menière's disease.

Patients with Meniere's disease were investigated for possible immunologic abnormalities. A total of 104 cases--55 bilateral and 49 unilateral--were examined. Immune activity was assessed using four types of immune parameters: (1) the erythrocyte sedimentation rate (ESR) and C-reactive protein levels (CRP); (2) serum immunoglobulin levels (IgG, IgM, and IgA); (3) complement levels (C3, C4, and CH50); and (4) autoantibody levels (rheumatoid factor, anti-DNA antibody, and antinuclear antibody). Patients with severe immunologic abnormalities (16% of the bilateral cases and 2% of the unilateral cases) typically displayed bilateral severe hearing loss, bilateral decreased vestibular response, and excellent responsiveness to steroid treatment. As patients with bilateral involvement account for approximately 30% of all cases of Meniere's disease in Japan, immunologic involvement may be assumed in about 6% of the total. The severity of these patients' symptoms and their responsiveness to steroid treatment suggest that the possibility of immunologic involvement is well worth investigation in Meniere's disease.