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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2020.tde-20082020-105934
Document
Author
Full name
Fátima Teresa Lacerda Brito de Oliveira
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2020
Supervisor
Committee
Júnior, Pérsio Roxo (President)
Massuda, Eduardo Tanaka
Silva, Marcos Tadeu Nolasco da
Title in Portuguese
Alterações otológicas e audiológicas em pacientes com deficiência de IgA, imunodeficiência comum variável e agamaglobulinemia
Keywords in Portuguese
Imunidade
Imunodeficiência
Perda auditiva
Abstract in Portuguese
As imunodeficiências primárias (IDP) são um conjunto de doenças com apresentações clínicas heterogêneas, nas quais os defeitos da imunidade humoral representam o grupo mais frequente. As principais manifestações clínicas são infecções de repetição de vias respiratórias. Objetivo: Identificar a ocorrência de alterações otorrinolaringológicas e audiológicas em pacientes com agamaglobulinemia, imunodeficiência comum variável e deficiência de IgA (seletiva e parcial). Pacientes e Métodos: Os pacientes foram avaliados por meio de: otoscopia, audiometria tonal e vocal, imitânciometria e registro de Potencial Evocado Auditivo de Tronco Encefálico (PEATE) estímulo clique. Resultados: Foram avaliados 30 pacientes, sendo 19 do sexo masculino. Desses, quatro apresentaram alterações auditivas nos exames de audiometria e foram excluídos para a análise de PEATE. A faixa etária variou entre 10-47 anos (média 22,4 anos), sendo a maioria maiores de 15 anos. À otoscopia foram identificados dois pacientes com otite média aguda, um paciente com otite média serosa e cinco pacientes com perfuração em membrana timpânica em pelo menos uma das orelhas. Na análise de PEATE houve diferença estatística na comparação eletrofisiológica das latências absolutas de onda I -OD, onda III- OD, onda III-OE e interpicos I-III-OE entre os sexos. Para a comparação de pacientes submetidos ao tratamento com imunoglobulinas, observou-se diferença estatisticamente significativa no PEATE em latência de onda III- OE, o mesmo tendo sido observado para pacientes com agamaglobulinemia. Conclusões: Os achados deste estudo evidenciam a necessidade de atenção a esta população, com protocolos clínicos de avaliação otológica e audiológica de rotina. Considerando a importância do diagnóstico precoce das IDP, novos estudos para avaliação do comprometimento auditivo central e subcortical serão necessários.
Title in English
Otological and audiological findings in patients with IgA deficiency, common variable immunodeficiency and agammaglobulinemia
Keywords in English
Hearing loss
Immunity
Immunodeficiency
Abstract in English
Primary immunodeficiencies (PID) are a group of diseases with heterogeneous clinical presentations, which humoral immunity defects represent the most frequent group. The main clinical manifestations are recurrent infections of the upper and lower respiratory tracts. Objective: Identify the occurrence of otorhinolaryngological and audiological findings in patients with agammaglobulinemia, common variable immunodeficiency and IgA deficiency (selective and partial). Patients and Methods: Patients were evaluated by means of: otoscopy, tonal and vocal audiometry, immittance testing and recording of Auditory Brain stem response (ABR) click stimulus. Results: Thirty patients were evaluated, 19 male and 11 female, however, four presented auditory alterations in the audiometry exams and were excluded for the ABR analysis. The age range varied between 10-47 years (average 22.4 years), the majority being over 15 years old. Otoscopy identified two patients with acute otitis media, one patient with secretory otitis media and five patients with tympanic membrane perforation in at least one ear. In the ABR analysis there was a statistical difference in the electrophysiological comparison of the absolute latencies of wave I - RE, wave III-RE, wave III-LE and interpeaks I-III-LE between genders. Comparing patients undergoing treatment with immunoglobulins, there was a statistically significant difference in ABR in wave latency III-LEand this result has also been observed in patients with agammaglobulinemia. Conclusions: The findings of this study show the need for attention to this population, with clinical protocols for routine otological and audiological evaluation. Considering the importance of early diagnosis of PID, further studies to assess central and subcortical hearing impairment will be necessary.
 
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Publishing Date
2020-10-21
 
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