メニエール病におけるヒスタミン加人免疫グロブリン治療の検討

HISTAMINE-γ-CLOBULIN COMPLEX THERAPY FOR MENIERE'S DISEASE

　Ⅰ．はじめに

　めまい，特にメニエール病と，即時型アレルギー反応の主な化学伝達物質であるヒスタミンとの関連について，以前から検討が加えられている^{2）4）7）8）11）19）}。一方，健康人の血清中にはヒスタミンに対する抵抗力としてヒスタミン防御力^3）や，ヒスタミンを不活性化する作用としてヒスタミン固定力^13）があり，気管支喘息などのアレルギー性疾患患者においくは，これらの能力が欠如ないしは減弱していることが報告^13）されている。Parrot^5）は人免疫グロブリンとヒスタミンを組み合わせることによつて，ヒスタミン固定力を高める薬剤としてHistaglobin^®を創製した。この薬剤はアレルギー性疾患に広く用いられているが，アレルギーとの関連が推測されるめまい症例に使用した報告はわれわれ^12）のほかには見出せなかつたPulec^16）はメニエール病の14％はアレルギーが原因であつたと述べているが，今回3例のメニエール病患者をこの薬剤により治療し，良い結果が得られたので，臨床的な面から検討を加えてみた。

　Three cases of Meniere's disease accompanied with allergic rhinitis were finally treated with histamine-γ-globulin complex (HG), after their vertiginous attacks had not subsided by other conservative treatments. In two cases of them HG-therapy was satisfactory.

　The first case was a 25-year-old engineer. He had an episode of remission of hearing loss from 51 to 8 dB, disappearance of vertigo and tinnitus since the day after allergen test was performed. During the test he had temporarily cornplained of dizziness. But recurrence of the cochleovestibular symptoms began three months later. HG injection started from the seventh month of the disease. After the third injection, vertigo had never occured in the following two years. Hearing had also been improved from 35 to 5 dB and tinnitus had disappeared after thirteen injections of HG.

　The secood case was a 14-year-old student suffered from vertigo and deafness for 13 months. He has been treated by 29 injections of HG. Definitive vertigo has ceased after the ninth injection and even dizzy sensation has disappeared in next ten months except for once. Hearing has improved from 39 to 5 dB.

　Another case was a 25-year-old engineer who showed partial improvement of cochleovestibular symptoms by interrupted HG-therapy. These results suggest that some of Meniere's disease can be connected with histamine release in their etiology.