Immunologic work-up study for inner ear disorders: Looking for a rational strategy

• Published in: Acta oto-laryngologica 2005-08, Vol.125 (8), p.814-818
• Main Authors: García-Berrocal, José Ramón, Trinidad, Almudena, Ramírez-Camacho, Rafael, Lobo, David, Verdaguer, José María, Ibáñez, Andrés
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antibodies, Antinuclear - analysis; Antinuclear antibodies; Autoimmune Diseases - diagnosis; Autoimmune Diseases - immunology; Biological and medical sciences; cost; Ear, Inner - immunology; Female; Hearing Loss, Sensorineural - diagnosis; Hearing Loss, Sensorineural - etiology; Hearing Loss, Sensorineural - immunology; Hearing Loss, Sudden - diagnosis; Hearing Loss, Sudden - etiology; Hearing Loss, Sudden - immunology; Humans; immune inner ear disease; Immunophenotyping; Labyrinth Diseases - diagnosis; Labyrinth Diseases - etiology; Labyrinth Diseases - immunology; lymphocytes; Lymphocytes - immunology; Male; Medical sciences; Meniere Disease - diagnosis; Meniere Disease - etiology; Meniere Disease - immunology; Middle Aged; Otorhinolaryngology. Stomatology; Retrospective Studies; Risk Factors; Serologic Tests; serological tests
• ISSN: 0001-6489; 1651-2251
• DOI: 10.1080/00016480510038059

Conclusions. For the evaluation of a patient with suspected immune-mediated inner ear disease (IMIED), an exhaustive immunologic work-up study is not recommended if financial resources are limited. Analysis of antinuclear antibodies (ANA) and the immunophenotype of peripheral blood lymphocytes (PBL) proved to be the most useful tests in our population to support the clinical diagnosis of IMIED. Objective. Owing to the lack of specific serological markers for the diagnosis of IMIED, an exhaustive immunologic work-up study for patients with suspected IMIED is usually performed. The aim of this study was to estimate the use of resources and the costs involved in the routine laboratory tests used for the diagnosis of IMIED. Material and methods. This was a comparative study of two groups of patients with a high suspicion of diverse clinical forms of IMIED who were subjected to different serologic test designs. The cost of the classical immunologic work-up study used for the diagnosis of IMIED (n=125) was estimated in comparison with that of a more restricted examination, based on a recently reported high-risk profile, involving the analysis of ANA and PBL (n=57). Results. The diagnostic efficiency of the two protocols was similar. The cost of a complete immunologic work-up study was €241.77 and that of the limited analysis was €53.12.