炎症性腸疾患に伴う感音難聴の臨床像

Inflammatory bowel disease (IBD) is an autoimmune disease that is often accompanied by extraintestinal manifestations such as arthritis, but reports of hearing loss as an extraintestinal manifestation of IBD are rare. In this study, we investigated the clinical features of sensorineural hearing loss associated with IBD. Patients with IBD and hearing loss who were registered between October 2005 and September 2022, in whom the diagnosis of ulcerative colitis (UC) or Crohn’s disease (CD) had been confirmed by gastroenterologists, and the hearing loss had been diagnosed as sensorineural hearing loss of unknown cause by otolaryngologists were included in this study. The study subjects were 32 patients (including nine female patients, 18 cases of UC, and 14 cases of CD) aged between 10 and 78 years old. Hearing loss associated with IBD was more common in males, and the median age at onset of hearing loss associated with UC was 56 years, while that associated with CD was 33 years. Two patients reported hearing loss preceding the onset of IBD on both sides, while 38 ears in 30 cases developed hearing loss after the onset of IBD. The hearing types varied among the 42 ears. Hearing loss developed within 10 years of the diagnosis of IBD in about 63% of cases, with a median interval of 9 years from the diagnosis of IBD in the 32 cases. In some cases, it was suspected that azathioprine and infliximab, both of which are therapeutic agents used for IBD, might have contributed to the hearing loss. However, other IBD medications were not suspected as having contributed to the hearing loss in any of the patients. The pathogenesis of hearing loss associated with IBD is still unknown, and clarification of the relationship between IBD and sensorineural hearing loss, and also the underlying pathophysiology through large-scale investigations is awaited.