A case of refractory otitis media with high-titer positive serum MPO-ANCA value

Naoto Azuma, Chieri Kanda, Aki Nishioka, Junpei Tanaka, Yasuo Mishiro, Jyuri Takehara, Hisashi Sawada, Masayasu Kitano, Mika Okabe, Mai Morimoto, Masahiro Sekiguchi, Takanori Kuroiwa, Naoaki Hashimoto, Kiyoshi Matsui, Tsuyoshi Iwasaki, Hajime Sano

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


A 56-year-old-woman presented a local otolaryngologist with a complaint of hearing loss. She was treated with antibiotics as acute otitis media, however her symptom did not improved. She admitted to our hospital because of hearing loss on both sides, fever, otorrhea and vertigo. On admission, an audiogram showed bilateral mixed conductive-sensorineural hearing loss, and CT image revealed the exudates in bilateral middle ear cavities and mastoid air cells. Moreover, serum level of myeloperoxidase anti-neutrophil cytoplasmic autoantibody (MPO-ANCA) elevated (133EU). Although pulmonary, renal and cutaneous involvements were not noted and the histopathological examination of operated specimen taken from otitis media revealed non-specific inflammatory changes, in the absence of any other obvious causes of otitis media, these findings might be associated with positive serum MPO-ANCA value itself. After the initiation of therapy with methylprednisolone and azathioprine, her symptoms and hearing ability ameliorated and both CRP value and the titer of ANCA became normalized. But, after the improvement by the immunosuppressive treatment, MRSA in the otorrhea persisted. This case suggests that otitis media may be one of the symptoms of vasculitis, and some previous cases described otitis media or hearing loss as rare manifestations of vasculitis. It is important to make an early diagnosis for good prognosis of hearing ability, and we have to consider the differential diagnosis including of ANCA-related vasculitis.

Original languageEnglish
Pages (from-to)99-104
Number of pages6
JournalJapanese Journal of Clinical Immunology
Issue number2
StatePublished - 2010


  • Hearing loss
  • Otitis media

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


Dive into the research topics of 'A case of refractory otitis media with high-titer positive serum MPO-ANCA value'. Together they form a unique fingerprint.

Cite this