Factitious hearing loss and otorrhea in an adolescent boy

Asialo, or beta(2), transferrin occurs in cerebrospinal fluid and a few oth er body fluids, e.g., perilymph and aqueous humor. It is used clinically as a marker protein to detect CSF otorrhea and rhinorrhea. Asialo-transferrin is separated from sialylated serum transferrin glycoforms by electrophores is and detected by Western blotting. Potential pitfalls in interpreting Wes tern blots occur when other transferrin isoforms approximate the migratory behavior of asialo-transferrin. In the present report an adolescent boy was seen by an otolaryngologist for otorrhea and acute hearing loss. The otorr hea fluid, subsequently identified as saliva, contained a transferrin isofo rm with electrophoretic mobility similar to that of asialo-transferrin. (C) 2000 Elsevier Science B.V. All rights reserved.