PB0763 - Sudden bilateral deafness revealing anti phospholipid syndrome

Monday, June 26, 2023

18:30 – 19:30 ET

Room: Exhibition

Co-Author(s)

YASMINA CHHIH, specialist in internal medicine

Doctor
internal medicine. Faculty of medicine. University Mohamed V. RABAT.MOROCCO
RABAT, Rabat-Sale-Zemmour-Zaer, Morocco

Co-Author(s)

WA

WAFA AMMOURI

Professeur
internal medicine.Faculty of medicine.University Mohamed V. Rabat.Morocco
RABAT, Rabat-Sale-Zemmour-Zaer, Morocco
FE

FATIMAZAHRA ELFEKAK

DOCTOR
internal medicine.Faculty of medicine.University Mohamed V. Rabat.Morocco
RABAT, Rabat-Sale-Zemmour-Zaer, Morocco
KH

KHIBRI HAJAR

Professeur
internal medicine.Faculty of medicine.University Mohamed V. Rabat.Morocco
RABAT, Rabat-Sale-Zemmour-Zaer, Morocco
MM

MOUNA MAAMAR

Professeur
internal medicine.Faculty of medicine.University Mohamed V. Rabat.Morocco
RABAT, Rabat-Sale-Zemmour-Zaer, Morocco
HH

Hicham HARMOUCHE

Prof.Dr
Internal medicine, Ibn Sina University Hospital Center, University Mohammed V, Rabat, Morocco
Rabat, Rabat-Sale-Zemmour-Zaer, Morocco

Presenting Author(s)

ZOUBIDA TAZI MEZALEK, MD (she/her/hers)

Professeur
Internal medicine - Clinical Hematology. Faculty of medicine.University Mohamed V. Rabat.Morocco
RABAT, Rabat-Sale-Zemmour-Zaer, Morocco

Background: Anti phospholipid syndrome is one of the rare causes of autoimmune deafness.

Aims: We report a case of bilateral deafness revealing an anti phospholipid syndrome

Methods: A case report

Results: 50-year-old woman with no pathological history presents for etiological assessment of bilateral deafness. The examination reveals cochleo-vestibular syndrome without any other associated mucocutaneous, articular or vascular sign. Otorhinolaryngological examination found bilateral vestibular areflexia and Cerebral MRI angiography was normal. A total scannographic vascular mapping in search of signs of vasculitis was without abnormality. The inflammatory assessment was negative. The immunological assessment showed positive anti-beta2 glycoprotein antibodies Igg 60 IU confirmed at 12-week intervals with positive anti-nuclear antibodies homogeneous at 1/160 and positive anti-Sm antibodies. The lupus activity report was negative, in particular negative anti-DNA antibodies and C3 and C4 not consumed. The cardiac and renal assessment was normal.
The diagnosis of anti phospholipid syndrome secondary to systemic lupus erythematosus was made.
The patient was put on curative coagulant treatment with low molecular weight heparin with a long-term antivitamin K relay as well as prednisone 1mg/kg/day with gradual reduction after 4 weeks and hydroxychloroquine. The evolution was marked by a clear improvement of the vestibular syndrome with persistence of bilateral deafness.

Conclusion(s): Autoimmune deafness is a pclinical entity which is neurosensory, rapidly progressive, disabling and often bilateral and associated with vestibular disorders. Lesions of the vascular stria and the spiral ligament with capillary or arteriolar micro-infarction are physiopathological hypotheses in particular in the context of the anti phospholipid syndrome: micro thrombi of the labyrinthine vascularization.The response to corticosteroid treatment is inconsistent. Its treatment is poorly codified and is based on corticosteroid therapy, immunosuppressive treatments in the event of corticosteroid resistance or transtympanic injections.