Lupus Anticoagulant Induced Sudden Profound Sensorineural Hearing Loss

A 15-year-old woman with systemic lupus erythematosus developed left lateral medullary syndrome and right internuclear ophthalmoplegia in 1987. Investigations revealed prolonged APTT, false positive serologic test for syphilis and elevated serum Ig-G, The clotting time of a 1:1 mixture of the patient's plasma and normal plasma was prolonged more than that of normal plasma alone, using the 1:5 diluted phospholipid reagent. These findings suggested that lupus anticoagulant (LAC) was responsible for development of thrombosis of the brainstem. The symptoms and signs were markedly improved by Prednisolone. In 1989, she had sudden profound sensorineural hearing loss (SNHL) in her right ear. Serologic test for syphilis was false positive and serum Ig-G was elevated again. These results and the presence of LAC imply that SNHL could be induced by thrombosis associated with LAC, although APTT was in normal range. The masking effect of daily administration of steroid from 1987 was assumed.