Progressive bilateral sensorineural hearing loss probably induced by chronic cyclosporin A treatment after renal transplantation for focal glomerulosclerosis

Acta Otolaryngol. 2004 Jun;124(5):603-7. doi: 10.1080/00016480410016225.

Abstract

Objective: The immunosuppressive agent cyclosporin A (CsA) has contributed to the success of organ and bone marrow transplantation. CsA-related neurotoxicity is a well-known occurrence. Sensorineural hearing loss (SNHL) due to initiation of CsA treatment is an extremely rare finding.

Material and methods: A 32-year-old man who had undergone technically uneventful cadaveric renal transplantation for focal glomerulosclerosis when 25 years old was evaluated as the result of a 10-month history of bilateral hearing loss. The patient had been taking only CsA (150 mg twice daily) and methylprednisolone.

Results: Progressive bilateral SNHL was confirmed by an audiological examination. Eight months after dose reduction of CsA, pure-tone audiometry excluded progression of hearing loss.

Conclusions: To the best of our knowledge, only rare cases of CsA-related hearing loss have been reported, and none after long-term CsA treatment. Audiological findings confirmed the cochlear origin of SNHL in our patient. The action of CsA on the blood-inner ear barrier has recently been demonstrated but the mechanism of cochlear damage is still unknown. A prospective study to determine the incidence of CsA-induced hearing loss has been instituted in our department.

Publication types

  • Case Reports

MeSH terms

  • Acoustic Impedance Tests
  • Adult
  • Audiometry, Evoked Response
  • Audiometry, Pure-Tone
  • Audiometry, Speech
  • Auditory Threshold / drug effects
  • Cochlea / drug effects
  • Cyclosporine / adverse effects*
  • Glomerulosclerosis, Focal Segmental / surgery
  • Hearing Loss, Bilateral / chemically induced*
  • Hearing Loss, Sensorineural / chemically induced*
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Kidney Transplantation* / methods
  • Male

Substances

  • Immunosuppressive Agents
  • Cyclosporine