TY  - JOUR
A1  - Köping, Maria
A1  - Shehata-Dieler, Wafaa
A1  - Schneider, Dieter
A1  - Cebulla, Mario
A1  - Oder, Daniel
A1  - Müntze, Jonas
A1  - Nordbeck, Peter
A1  - Wanner, Christoph
A1  - Hagen, Rudolf
A1  - Schraven, Sebastian P.
T1  - Characterization of vertigo and hearing loss in patients with Fabry disease
JF  - Orphanet Journal of Rare Diseases
N2  - Background
Fabry Disease (FD) is an X-linked hereditary lysosomal storage disorder which leads to a multisystemic intralysosomal accumulation of globotriaosylceramid (Gb3). Besides prominent renal and cardiac organ involvement, patients commonly complain about vestibulocochlear symptoms like high-frequency hearing loss, tinnitus and vertigo. However, comprehensive data especially on vertigo remain scarce. The aim of this study was to examine the prevalence and characteristics of vertigo and hearing loss in patients with FD, depending on renal and cardiac parameters and get hints about the site and the pattern of the lesions.

Methods
Single-center study with 57 FD patients. Every patient underwent an oto-rhino-laryngological examination as well as videonystagmography and vestibular evoked myogenic potentials (VEMPs) and audiological measurements using pure tone audiometry and auditory brainstem response audiometry (ABR). Renal function was measured by eGFR, cardiac impairment was graduated by NYHA class.

Results
More than one out of three patients (35.1%) complained about hearing loss, 54.4% about vertigo and 28.1% about both symptom. In 74% a sensorineural hearing loss of at least 25 dB was found, ABR could exclude any retrocochlear lesion. Caloric testing showed abnormal values in 71.9%, VEMPs were pathological in 68%. A correlation between the side or the shape of hearing loss and pathological vestibular testing could not be revealed.

Conclusions
Hearing loss and vertigo show a high prevalence in FD. While hearing loss seems due to a cochlear lesion, peripheral vestibular as well as central nervous pathologies cause vertigo. Thus, both the site of lesion and the pathophysiological patterns seem to differ.
KW  - Fabry disease
KW  - vertigo
KW  - VEMP
KW  - cardiomyopathy
KW  - chronic kidney disease
KW  - lysosomal storage disorder
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-222818
VL  - 13
ER  -