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Plasma antidiuretic hormone in cases with the early onset of profound unilateral deafness.

Takeda T, Kakigi A, Nishioka R, Taguchi D, Nishimura M

Department of Otolaryngology, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan.

OBJECTIVE: The p-ADH level in cases of juvenile unilateral profound deafness (JUPD) and the timecourse of the level were examined to investigate whether or not an increase of p-ADH is involved in the development of delayed endolymphatic hydrops (DEH) in JUPD. MATERIALS AND METHODS: In 90 consecutive patients with unilateral profound or total sensorineural deafness with the onset in early childhood, pure-tone audiometric examination and the measurement of p-ADH and plasma osmolality (p-OSM) were followed up once or twice a year as far as possible. At every testing, we performed careful history-taking about episodic vertigo/dizziness, fluctuant hearing loss, and tinnitus in order to find out whether patients had experienced these clinical signs of the development of DEH. RESULTS: Means and standard deviation (S.D.) of p-ADH level and osmolality in all samples tested (n=368) were 7.3+/-7.0pg/mL (0.7-52.0pg/mL), and 288.6+/-4.4mOsm/L (273-306mOsm/L), respectively. The mean of p-ADH level was much higher than those previously reported in children and adolescents. High levels of p-ADH (over 5.0pg/mL) were often observed in subjects between 6 and 19 years of age, but not so frequently in subjects of 20 years of age or older. Long-term follow-up of p-ADH levels revealed that DEH frequently developed in cases with persistent elevation of p-ADH. CONCLUSIONS: The elevation of p-ADH is likely to promote the development of DEH in cases of JUPD, although the underlying mechanism remains to be elucidated.

Published 10 March 2008 in Auris Nasus Larynx.
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