An Unusual Presentation Of Sarcoidosis With Progressive Hearing Loss

ObjectiveWe present a case report of a 52 year old female in whom the first and only presenting symptom of sarcoidosis was hearing loss. Neurosarcoidosis is a rare condition and published data are limited to case reports and small case series. A small number of cases with hearing loss as an initial symptom have been described, however all have also had other neurological disturbances. Case ReportThe patient presented to emergency outpatient clinic with sudden deterioration in hearing but was otherwise asymptomatic. Initial investigations suggested a diagnosis of ossicular fixation, however, her hearing rapidly and progressively deteriorated over the following months. Further investigation revealed raised serum angiotensin converting enzyme and anti-nuclear factor and suggested a diagnosis of sarcoidosis, however, there was no discrete lesion to make a tissue diagnosis. Treatment with high dose oral steroids failed to improve her symptoms, the efficacy of which has been debated in the literature. ConclusionThe Otolaryngologist should consider an autoimmune cause in any patient with unexplained hearing loss.