Prevalência de doença imunomediada do ouvido interno (DIMOI) e de anticorpos anti-Hsp70 em vitiligo não segmentar
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Data
2022-06-27
Autores
Marchioro, Helena Zenedin
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Universidade Estadual Paulista (Unesp)
Resumo
Fundamentos: A perda auditiva neurossensorial (PANS) é comum em indivíduos com vitiligo não segmentar (VNS). Até o momento, a patogênese desse processo não foi investigada. A concomitância de doenças autoimunes no VNS justifica explorar a doença imunomediada do ouvido interno (DIMOI), como a etiologia de PANS em VNS. O anticorpo anti-HSP70 é um marcador sorológico de DIMOI, podendo auxiliar no diagnóstico precoce dessa doença. Objetivos: Avaliar a prevalência de DIMOI e de anticorpos anti-Hsp70 em indivíduos com VNS. Métodos: Estudo transversal, envolvendo adultos, de ambos os sexos, com VNS, submetidos a audiometria e dosagem sérica de anticorpos anti-Hsp70. Não foram incluídos portadores de câncer, imunossuprimidos ou portadores de doenças reumatológicas em atividade. Resultados: Foram avaliados 112 indivíduos adultos com VNS. PANS bilateral foi encontrada em 28 (25,0%; IC95% 17,9–32,1%) participantes, sendo que 17 (15,2%; IC95% 9,8–20,5%) apresentavam PANS não explicada por outra causa, como diabetes, infecção e drogas ototóxicas. A prevalência do anticorpo anti-Hsp70 foi de 26,8% (IC95% 19,6-33,9%). Foram identificados seis participantes (5,4%; IC95% 2,7–8,0%) com critérios para DIMOI. Pacientes com DIMOI apresentaram idade mediana mais tardia do início do vitiligo (46 vs. 32 anos; p=0,04), menor extensão do vitiligo (VES 0,4 vs. 1,8; p=0,027), e níveis maiores de anti-Hsp70 (221 vs. 85 ng/mL; p<0,01). Conclusões: DIMOI e anticorpos anti-Hsp70 são prevalentes em adultos com VNS.
Background: Sensorineural hearing loss (SNHL) is associated with non-segmental vitiligo (NSV). To date, the pathogenesis of this association has not been explored. The concomitance of autoimmune disease in vitiligo patients justifies the investigation of immune-mediated inner ear disease (IMIED) as a cause of SNHL in NSV. The anti- Hsp70 antibody is a serological marker of IMIED, and it might help on the early diagnosis of this disease. Objective: To evaluate the prevalence of IMIED and anti-Hsp70 antibody in NSV patients. Methods: Cross-sectional study involving NSV adult patients of both genders, who were evaluated through audiometry and serological dosage of anti-Hsp70 antibody. There were not included individuals with diagnosis of cancer, immunosuppressed or those with autoimmune rheumatological disease. Results: One hundred and twelve individuals were evaluated. Bilateral SNHL was found in 28 (25.0%; 95%CI 17.9–32.1%) patients. Among those, 17 (15.2%; 95%CI 9.8–20.5%) had SNHL that could not be explained by other causes, as diabetes, infection, noise exposition or ototoxic drugs. The prevalence of anti-Hsp70 antibody was 26.8% (95%CI 9.8–20.5%). Six patients (5.4% CI95% 2.7–8.0%) had diagnostic criteria for IMIED. Patients with IMIED had latter median age of onset of vitiligo (46 vs. 32 years old; p=0.04), lesser disease extent (VES 0.4 vs. 1.8; p=0.03), and higher levels of anti-Hsp70 antibodies (221 vs. 85 ng/ml; p <0.01). Limitations: Lack of follow-up and audiometric recovery after corticotherapy. Exclusion of individuals with autoimmune rheumatologic diseases, which could underestimate the prevalence of IMIED in this sample. Conclusion: IMIED and anti-Hsp70 antibodies are prevalent in NSV adult patients.
Background: Sensorineural hearing loss (SNHL) is associated with non-segmental vitiligo (NSV). To date, the pathogenesis of this association has not been explored. The concomitance of autoimmune disease in vitiligo patients justifies the investigation of immune-mediated inner ear disease (IMIED) as a cause of SNHL in NSV. The anti- Hsp70 antibody is a serological marker of IMIED, and it might help on the early diagnosis of this disease. Objective: To evaluate the prevalence of IMIED and anti-Hsp70 antibody in NSV patients. Methods: Cross-sectional study involving NSV adult patients of both genders, who were evaluated through audiometry and serological dosage of anti-Hsp70 antibody. There were not included individuals with diagnosis of cancer, immunosuppressed or those with autoimmune rheumatological disease. Results: One hundred and twelve individuals were evaluated. Bilateral SNHL was found in 28 (25.0%; 95%CI 17.9–32.1%) patients. Among those, 17 (15.2%; 95%CI 9.8–20.5%) had SNHL that could not be explained by other causes, as diabetes, infection, noise exposition or ototoxic drugs. The prevalence of anti-Hsp70 antibody was 26.8% (95%CI 9.8–20.5%). Six patients (5.4% CI95% 2.7–8.0%) had diagnostic criteria for IMIED. Patients with IMIED had latter median age of onset of vitiligo (46 vs. 32 years old; p=0.04), lesser disease extent (VES 0.4 vs. 1.8; p=0.03), and higher levels of anti-Hsp70 antibodies (221 vs. 85 ng/ml; p <0.01). Limitations: Lack of follow-up and audiometric recovery after corticotherapy. Exclusion of individuals with autoimmune rheumatologic diseases, which could underestimate the prevalence of IMIED in this sample. Conclusion: IMIED and anti-Hsp70 antibodies are prevalent in NSV adult patients.
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Palavras-chave
Autoimunidade, Perda auditiva neurossensorial, Vitiligo, Hsp70, Ouvido interno, Autoimmunity, Sensorineural hearing loss, Inner ear, Labirintos (Ouvidos)