Aldosterone assessment in patients with Meniere's disease

Since 1938 endolymphatic hydrops has generally been accepted as the basic h istopathological substrate of Meniere's disease. In animal studies it has b een found that exogenous administration of aldosterone resulted in endolymp hatic hydrops. Manifestations of Meniere's disease are frequently observed in times of emotional stress. Mediated through the hypothalamus, stress lea ds to an increased secretion of adrenocorticotropic hormone from the anteri or pituitary gland, followed by an increased adrenocortical production of g lucocorticoids (cortisol and corticosterone) and mineralocorticoids (aldost erone). We addressed the question whether plasma aldosterone levels, like i n guinea pigs, would be increased in patients with Meniere's disease, As pa rt of a diagnostic protocol a clinical prospective cohort study was therefo re performed on 89 patients with Meniere's disease to assess plasma aldoste rone levels. Plasma aldosterone was not elevated in Meniere patients compar ed to plasma aldosterone in a control group of 27 normal subjects. No stati stically significant differences were found in plasma aldosterone between u ni- and bilateral Meniere's disease. Plasma aldosterone levels did not corr elate with age, average hearing loss, duration or perceived severity of sub jective complaints (vertigo, hearing loss, tinnitus and aural pressure). In this study plasma aldosterone was not elevated in patients with Meniere's disease compared to normal subjects. Plasma aldosterone can thus not be use d as a diagnostic tool for Meniere's disease. In conclusion: No anomalous p lasma aldosterone levels were found in Meniere patients during an attack-fr ee period. The question whether plasma aldosterone and cortisol levels show variations before, during and after an attack remains to be answered. If s o, this might contribute to a better understanding of the pathophysiologica l mechanism of Meniere's disease. Copyright (C) 2001 S. Karger AG, Basel.