The International Tinnitus Journal

Acute Peripheral Vertigo: Involvement of the Hemostatic System

Author(s): Bruno Fattori, Andrea Nacci, P.L. Pier Luigi Ghilardi, Luca Bruschini, Fabio Matteucci, and Francesco Ursino

Viral infection is the most frequent cause of unilateral acute peripheral vestibulopathy (APV). Another possible cause is a vascular disorder in the labyrinth area associated with alterations in hemostasis. In a group of 45 patients with APV and in a series of 25 patients with Meniere's disease (control group), we evaluated blood parameters, including total cholesterol, triglycerides, apolipoprotein A and B, lipoprotein (a), homocysteine, folate, prothrombin time, activated partial thromboplastin time, D-dimer, fibrinogen, antithrombin III, protein C, protein S, activated protein C resistance, and anticardiolipin antibodies. In the acute phase of their disease, the patients with APV exhibited increased plasma levels of fibrinogen (341.5 ± 136.8 standard deviation [SD] versus 268.1 ± 72.6 SD mg/dl;p = .05); increased plasma levels ofD-dimer (305 ± 158 SD versus 201 ± 106 SD ng/dl;p = .008); enhanced plasma levels of lipoprotein (a) (42.6 ± 38.5 SD versus 16.9 ± 17.7 SDmg/dl; F = 5.67,p = .02); high leukocyte count (9.2 ± 2.7 SD versus 6.4 ± 1.2 SD X 1Q3/J.L1; F = 8.42,p < .006); and low serum folate concentration (5.1 ± 1.7 SD versus 7.2 ± 2.6 SD ng/ml; F = 4.34 ,p = .04). During follow-up, the prothrombin time was prolonged (p = .04), and leukocyte count was decreased (p < .019) in the patients with APV, whereas fibrinogen, D-dimer, lipoprotein (a), and folate were unchanged. In this study, we demonstrated that patients with APV exhibit significant involvement of the hemostatic system.

PDF