Amit ashish surgery pdf books4/9/2023 The patient was diagnosed with autoimmune ear disease (AIED) and started on corticosteroids. Ileocolonoscopy showed pancolitis, and histopathology was negative for dysplasia or malignancy. Magnetic resonance cholangiopancreatography showed multifocal narrowing alternating with mildly dilated segments ( Figure 1B), suggestive of primary sclerosing cholangitis (PSC). Incidentally, on routine investigations, his liver function test revealed cholestatic pattern of liver enzyme abnormality (total bilirubin, 1.4mg/dL direct bilirubin, 0.7mg/dL SGOT/SGPT, 81/66 IU/L alkaline phosphatase, 1793 IU/L). Pure tone audiometry was suggestive of bilateral profound sensorineural hearing loss (SNHL), as shown in Figure 1A and antinuclear antibody was positive (Titre 1:40). Otoscopy, tympanometry, and magnetic resonance imaging of brain and internal auditory meatus were normal. The patient denied history of ear disease in family members, exposure to intense noisy environment, and ototoxic drug intake. A 39-year-old male who had a known case of ulcerative colitis for the last 8 years presented with sudden onset vertigo and tinnitus, followed by decreased hearing in the right ear for the previous 2 months.
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