Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-14T11:14:07.516Z Has data issue: false hasContentIssue false
  • English
  • Français

Acute unilateral sensorineural hearing loss associated with anabolic steroids and polycythaemia: case report

Published online by Cambridge University Press:  14 December 2015

T Tikka ,
N Mistry  and
A Janjua
T Tikka*
Affiliation:
Department of ENT, Birmingham Heartlands (Teaching) Hospital, UK
N Mistry
Affiliation:
Department of ENT, Birmingham Heartlands (Teaching) Hospital, UK
A Janjua
Affiliation:
Department of ENT, Birmingham Heartlands (Teaching) Hospital, UK
*
Address for correspondence: Miss Theofano Tikka, ENT Department, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Unilateral sudden sensorineural hearing loss due to an infarct in the vertebrobasilar system has been widely reported. Most patients have a background of traditional coronary risk factors related to these cerebrovascular episodes.

Case report:

A 32-year-old male, a regular user of anabolic steroids, presented to the emergency department with unilateral sensorineural hearing loss and symptoms suggestive of an infarct of the anterior inferior cerebellar artery but in the absence of risk factors for ischaemic stroke.

Results:

Magnetic resonance imaging confirmed the presence of infarction in the region supplied by the anterior inferior cerebellar artery. Polycythaemia was found on haematological analysis, which we believe was secondary to the use of anabolic steroids. The patient was commenced on aspirin as per the stroke management protocol. There was resolution of neurological symptomatology six weeks after the episode, but no improvement in hearing.

Conclusion:

To our knowledge, this is the first case report of unilateral sensorineural hearing loss secondary to the use of anabolic steroids causing polycythaemia. This cause should be considered in the differential diagnosis of patients presenting with sensorineural hearing loss, especially in young males, when no other risk factors can be identified.

Keywords

Hearing Loss, SensorineuralHearing Loss, SuddenAnabolic AgentsSteroidsPolycythemia
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 3 , March 2016 , pp. 309 - 313
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Lee, H, Whitman, GT, Lim, JG, Lee, SD, Park, YC. Bilateral sudden deafness as a prodrome of anterior inferior cerebellar artery infarction. Arch Neurol 2001;58:1287–9CrossRefGoogle ScholarPubMed
2Lee, H, Sohn, SI, Jung, DK, Cho, YW, Lim, JG, Yi, SD et al. Sudden deafness and anterior inferior cerebellar artery infarction. Stroke 2002;33:2807–12CrossRefGoogle ScholarPubMed
3Oas, JG, Baloh, RW. Vertigo and the anterior inferior cerebellar artery syndrome. Neurology 1992;42:2274–9CrossRefGoogle ScholarPubMed
4Lee, H, Kim, JS, Chung, EJ, Yi, HA, Chung, IS, Lee, SR et al. Infarction in the territory of anterior inferior cerebellar artery: spectrum of audiovestibular loss. Stroke 2009;40:3745–51CrossRefGoogle ScholarPubMed
5Martines, F, Dispenza, F, Gagliardo, C, Martines, E, Bentivegna, D. Sudden sensorineural hearing loss as prodromal symptom of anterior inferior cerebellar artery infarction. ORL J Otorhinolaryngol Relat Spec 2011;73:137–40CrossRefGoogle ScholarPubMed
6Ikegami-Takada, T, Izumikawa, M, Doi, T, Takada, Y, Tomoda, K. AICA syndrome with facial palsy following vertigo and acute sensorineural hearing loss. Auris Nasus Larynx 2012;39:244–8CrossRefGoogle ScholarPubMed
7Lee, H. Audiovestibular loss in anterior inferior cerebellar artery territory infarction: a window to early detection? J Neurol Sci 2012;313:153–9CrossRefGoogle ScholarPubMed
8Hausler, R, Levine, R. Auditory dysfunction in stroke. Acta Otolaryngol 2000;120:689–703Google ScholarPubMed
9Lee, H. Sudden deafness related to posterior circulation infarction in the territory of the nonanterior inferior cerebellar artery: frequency, origin, and vascular topographic pattern. Eur Neurol 2008;59:302–6CrossRefGoogle Scholar
10Lee, EJ, Yoon, YJ. Sudden deafness as an initial presenting symptom of posterior inferior cerebellar artery infarction: two case reports. J Laryngol Otol 2014;128:1011–14CrossRefGoogle ScholarPubMed
11Muttikkal, TJ, Kesser, BW, Mukherjee, S. Isolated contralateral sudden sensorineural hearing loss: an unusual manifestation of pontine infarct. Neuroradiol J 2014;27:483–6CrossRefGoogle ScholarPubMed
12Doyle, KJ, Fowler, C, Starr, A. Audiological findings in unilateral deafness resulting from contralateral pontine infarct. Otolaryngol Head Neck Surg 1996;114:482–6CrossRefGoogle ScholarPubMed
13Lee, H, Baloh, RW. Sudden deafness in vertebrobasilar ischemia: clinical features, vascular topographical patterns and long-term outcome. J Neurol Sci 2005;228:99–104CrossRefGoogle ScholarPubMed
14Screiber, BE, Agrup, C, Haskart, DO, Luxon, LM. Sudden sensorineural hearing loss. Lancet 2010;375:1203–11CrossRefGoogle Scholar
15Cecchi, E, Mannini, L, Abbate, R. Role of hyperviscosity in cardiovascular and microvascular diseases [in Italian]. G Ital Nefrol 2009;26(suppl 46):20–9Google ScholarPubMed
16Capaccio, P, Pignataro, L, Gaini, LM, Sigismund, PE, Novembrino, C, De Giuseppe, R et al. Unbalanced oxidative status in idiopathic sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 2012;269:449–53CrossRefGoogle ScholarPubMed
17Rudack, C, Langer, C, Stoll, W, Rust, S, Walter, M. Vascular risk factors in sudden hearing loss. Thromb Haemost 2006;95:454–61CrossRefGoogle ScholarPubMed
18Mosnier, I, Stepanian, A, Baron, G, Bodenez, C, Robier, A, Meyer, B et al. Cardiovascular and thromboembolic risk factors in idiopathic sudden sensorineural hearing loss: a case-control study. Audiol Neurootol 2011;16:55–66CrossRefGoogle ScholarPubMed
19Flint, PW, Haughey, BH, Lund, VJ, Niparko, JK, Richardson, MA, Robbins, KT et al. Cummings Otolaryngology – Head and Neck Surgery, 5th edn.Philadelphia: Mosby Elsevier, 2010Google Scholar
20Lin, RJ, Krall, R, Westerberg, BD, Chadha, NK, Chau, JK. Systematic review and meta-analysis of the risk factors for sudden sensorineural hearing loss in adults. Laryngoscope 2012;122:624–35CrossRefGoogle ScholarPubMed
21Kopera, H. Side effects of anabolic steroids and contraindications. Wien Med Wochenschr 1993;143:399–400Google ScholarPubMed
22Verwilghen, R, Louwagie, A, Waes, J, Vandenbroucke, J. Anabolic agents and relative polycythaemia. Br J Haematol 1966;12:712–16CrossRefGoogle ScholarPubMed
23Viallard, JF, Marit, G, Mercie, P, Leng, B, Reiffers, J, Pellegrin, JL. Polycythaemia as a complication of transdermal testosterone therapy. Br J Haematol 2000;110:237–8CrossRefGoogle ScholarPubMed
24Bozzini, CE, Alippi, RM. The erythrogenic effect of steroids with predominant anabolic or androgenic activity in the polycythemic mouse. Horm Metab Res 1971;3:52–4CrossRefGoogle ScholarPubMed
25Gorshein, D, Murphy, S, Gardner, FH. Comparative study on the erythropoietic effect of androgens and their mode of action. J Appl Physiol 1973;35:276–8CrossRefGoogle ScholarPubMed
26Low-Beer, TS, Scott, GS. Polycythaemia in androgen-dependent anaplastic anaemia. Br Med J 1976;1:197–8CrossRefGoogle Scholar
27Stergiopoulos, K, Brennan, JJ, Mathews, R, Setaro, JF, Kort, S. Anabolic steroids, acute myocardial infarction and polycythemia: a case report and review of the literature. Vasc Health Risk Manag 2008;4:1475–80CrossRefGoogle ScholarPubMed
28Kennedy, MC, Lawrence, C. Anabolic steroid abuse and cardiac death. Med J Aust 1993;158:346–8CrossRefGoogle ScholarPubMed
29McNutt, RA, Ferenchick, GS, Kirlin, PC, Hamlin, NJ. Acute myocardial infarction in a 22-year-old world class weight lifter using anabolic steroids. Am J Cardiol 1988;62:164CrossRefGoogle Scholar
30McCarthy, K, Tang, AT, Dalrymple-Hay, MJ, Haw, MP. Ventricular thrombosis and systemic embolism in bodybuilders: etiology and management. Ann Thorac Surg 2000;70:658–60CrossRefGoogle ScholarPubMed
31Mewis, C, Spyridopoulos, I, Kühlkamp, V, Seipel, L. Manifestation of severe coronary heart disease after anabolic drug abuse. Clin Cardiol 1996;19:153–5CrossRefGoogle ScholarPubMed
32Nieminen, MS, Rämö, MP, Viitasalo, M, Heikkilä, P, Karjalainen, J, Mäntysaari, M et al. Serious cardiovascular side effects of large doses of anabolic steroids in weight lifters. Eur Heart J 1996;17:1576–83CrossRefGoogle ScholarPubMed
33Harston, GW, Batt, F, Fan, L, Okell, TW, Sheerin, F, Littlewood, T et al. Lacunar infarction associated with anabolic steroids and polycythemia: a case report. Case Rep Neurol 2014;6:34–7CrossRefGoogle ScholarPubMed