Abstract: PUB053
Sudden Bilateral Sensorineural Hearing Loss in a Patient with Antiphospholipid Antibody Syndrome and ESRD
Session Information
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Dukkipati, Ramanath B., Harbor-UCLA Medical Center, Torrance, California, United States
- Shankar, Abhirami, Harbor-UCLA Medical Center, Torrance, California, United States
- Ugalde, Anne-Lorrane A., Harbor-UCLA Medical Center, Torrance, California, United States
Introduction
Antiphospholipid syndrome (APS) can affect many locations in the central nervous system and has been associated with stroke, chorea, headaches and sudden deafness.We report a patient who has ESRD due to Diabetic Nephropathy with sudden hearing loss who subsequently demonstrated positivity for anticardiolipin antibodies (aCL)
Case Description
60 year old M with ESRD due to kidney biopsy proven Diabetic Nephropathy is on Hemodialysis for 8 monhts when he presented with sudden onset of bilateral sensoroneuronal hearing loss.Work up revealed positive IgG anti cardiolipin,beta 2 microglobulin antibodies and Lupus anti-coagulant. MRI of the audotory canals showed mild enhancement in the region of cochlea. MR angiogram of head and neck showed occulsion of the left cervial vertebral artery.Infarcts were seen in the posterior cerebellum and small chronic infarcts in the right cerebllum and right pons.He was started on Warfarin. The hearing loss has not resolved at the time of this submission. ANA and both PR3 and MPO ANCA were positive but there was no evidence of vascultisi and did not satisfy the diagnosis of SLE.
Discussion
Sudden Hearing loss can be a clinical manifestation of SLE and Anti-phospholipid antibody syndrome or Primary Antiphospholipid antibody syndrome.Our patient had kidney biopsy proven Diabetic Nephropathy with no evidence of Lupus Nephritis . It is important to do a complete work up of sensorineuronal hearing loss in dialysis patients.