Sudden Hearing Loss Associated with High Levels of Calcineurin Inhibitors after Liver Transplantation
Keywords
liver transplantationsudden hearing loss
immunosuppression
neurotoxicity syndromes
cyclosporine
tacrolimus
Medicine (General)
R5-920
Medicine
R
DOAJ:Medicine (General)
DOAJ:Health Sciences
Medicine (General)
R5-920
Medicine
R
DOAJ:Medicine (General)
DOAJ:Health Sciences
Medicine (General)
R5-920
Medicine
R
Medicine (General)
R5-920
Medicine
R
Medicine (General)
R5-920
Medicine
R
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Show full item recordAbstract
Hearing impairment in patients after liver transplantation (OLT) has only been reported sporadically. However, potential ototoxic side effects may be related to immunsuppression. We report a series of 5 patients who developed sudden hearing loss after OLT and presented high levels of calcineurin inhibitors at the same time. In 4/5 patients, sudden hearing loss was bilateral. Patients` main characteristic were very heterogenous (e.g. age, time since OLT, underlying liver disease). Sudden hearing loss occured under high levels of tacrolimus (n=3, mean serum levels at the time of hearing loss: 24 ng/ml) and cyclosporine A (n=2, 343 ng/ml), respectively. Further immunosuppression consisted of prednisolone (n=4) and azathioprine (n=1). There were no other risk factors such as administration of ototoxic drugs. Levels of immunsuppressants were rapidly corrected after the event. Nevertheless, in 4/5 patients hearing aids (3/4 bilateral) became necessary during follow-up. Furthermore, two patients suffer from tinnitus since the hearing loss. In conclusion, high levels of calcineurin-inhibitors after OLT seem to be a risk factor for sudden hearing loss. In most cases, hearing loss was irreversible and resulted in need of a hearing aid. Neurotoxicity may be a probable mechanism. Further evaluations are necessary to allow a better understanding of the problem.Date
2006-03-01Type
ArticleIdentifier
oai:doaj.org/article:635475f140cd4d8e8bebf3f0f13db8720946-9648
https://doaj.org/article/635475f140cd4d8e8bebf3f0f13db872
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