Hemostatic alterations in patients with acute, unilateral vestibular paresis

OBJECTIVES: The etiopathogenesis of acute unilateral peripheral vestibulopa thy (APV) still remains a matter of debate; ischemic changes in the circula tion of the labyrinth may play a role. We consequently looked for possible hemostasis alterations in a group of patients with APV of an unknown nature . METHODS: We evaluated blood parameters known to be involved In circulatio n disorders, including total and HDL cholesterol, tryglycerides, apolipopro tein A and B, lipoprotein(a), homocysteine, folate, prothrombin time, activ ated partial thromboplastin time, fibrinogen, D-dimer, antithrombin ill, pr otein C, protein S, activated protein C resistance, and anticardiolipin IgG and IgM antibodies. A series of 23 patients affected with APV were consecu tively referred to our department, in the acute phase, before treatment, an d in the follow-up phase after 4 to 6 weeks of pharmacologic washout. The a forementioned blood parameters were also measured in a series of 15 patient s with Meniere's disease. RESULTS: The patients with APV in the acute phase compared with the patients with Meniere's disease In the acute phase exhib ited increased plasma levels of fibrinogen (mean, 338.3 +/- 135.9 SD vs 271 .3 +/- 69.8 SD mg/dL, P = 0.05), increased plasma levels of D-dimer (mean, 320 +/- 207.8 SD vs 226.7 +/- 138.7 SD NG/mL), enhanced plasma levels of li poprotein(a) (41.4 +/- 38.6 SD vs 16 +/- 18.2 SD mg/dL, F = 5.67, P = 0.02) , high leukocyte count (9.1 +/- 2.7 SD vs 6.5 +/- 1.3 SD x 10(3)/muL; F = 8 .42, P < 0.006), and low serum folate concentration (5.3 <plus/minus> 1.8 S D vs 7.1 +/- 2.7 NG/mg; F = 4.34, P = 0.04). During follow-up the prothromb in time was prolonged (F = 4.34, P= 0.04) and leukocyte count decreased (F = 7.39, P < 0.019) in the APV patients, whereas fibrinogen, D-dimer, lipopr otein(a), and folate were unchanged. CONCLUSION: Our results provide eviden ce suggesting an involvement of the hemostatic system in APV.