Diagnostic tests for suspected IMIED

Diagnostic tests for suspected IMIED

What diagnostic workup is indicated in a patient suspected of having IMIED?

Immediate referral to an otolaryngologist is necessary. Routine history, physical exam, and diagnostic tests including a CBC, comprehensive metabolic panel, ESR, CRP, testing for syphilis, and MRI to exclude a retrocochlear lesion should be performed to evaluate for other causes of SNHL or an associated systemic process. Disease severity should be measured at baseline and followed serially with audiograms.

The role of testing for ANCA, ANA, RF, complement levels, and APS studies in patients with no other evidence of a systemic autoimmune illness is unclear. ANA, RF, low-moderate titer antiphospholipid antibodies, and antithyroid antibodies are frequently detected in patients with IMIED who lack features of systemic disease and the antibodies do not have clear prognostic value in this setting.


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