Steroid-Responsive Sensorineural Hearing Loss in a Patient with Idiopathic Thrombocytopenic Purpura.

A 43-year-old female with steroid-responsive sensorineural hearing loss (SNHL) was described. She had been treated with steroids for idiopathic thrombocytopenic purpura (ITP) since 1981.The patient complained of sudden hearing loss and tinnitus in the left ear on the 9th of June, 1995, at which time, 2.5mg of prednisolone was administered for ITP. The audiogram showed SNHL of low frequency sounds. Immunological studies showed positive rheumatoid factor and antinuclear antibody, high levels of complement, immune complex, IgG and IgA.The patient's hearing improved after initial treatment with 40mg of prednisolone. Fluctuations in hearing loss were observed with changes in the dose of prednisolone. The above clinical course suggested steroid-responsive SNHL.Steroid administration could be reduced with a supplemental administration of Saireito without any significant deterioration of hearing. Laboratory studies and the effect of steroids suggest a causative role in immune-mediated inner ear disorders.