363. THE ONSET AND TREATMENT OF OTITIS MEDIA ASSOCIATED WITH EOSINOPHILIC GRANULOMATOUS POLYANGIITIS (EGPA)
Bibliographic record
Abstract
Background: Otitis media with ANCA associated vasculitis (OMAAV) are sometimes initial symptom of ANCA associated vasculitis. To present eight cases of hearing loss associated with eosinophilic granulomatosis with polyangiitis (EGPA) and to discuss the onset, treatment and mechanisms of hearing impairment after steroid instillation and immunosuppressive with/without anti IL-5 therapy. Methods: Patients: Eight patients were referred to our University Hospital from 2004 to 2018 with intractable otitis media with eosinophil infiltration to the middle ear and progressive mixed (conductive and sensorineural) hearing loss. Interventions: Diagnosis and treatment. Main outcome measures: Otologic and rhinological symptoms, resistance for steroid instillation and analysis of cochlear function before and after treatment. Results: Eight cases (three male, five female; aged 35–74; one MPO-ANCA positive, one PR3-ANCA positive) were included in this study all presenting middle ear effusion with eosinophil infiltration. In one case, hemi/bilateral facial palsy (12.5%) was also reported prior to diagnosis (10 months). Seven cases were treated as eosinophilic otitis media one to 10 years after bronchial asthma and chronic sinusitis presented. Four cases were diagnosed as EGPA one to six years after otologic symptoms appeared. The administration of triamcinolone acetonide was effective at controlling these symptoms; however, immunosuppression therapy with/without anti IL-5 therapy were necessary for advanced cases. Conclusion: This study highlights the difficulties in diagnosing localized EGPA and the effectiveness of steroid instillation if an early diagnosis can be obtained. Our findings also indicate that the otologic symptoms and resistance for steroid instillation may be an indicator and importance of differentiating EGPA-associated otitis media from eosinophilic otitis media diagnostically. Disclosures: None
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".