Seronegative Propylthiouracil-Induced Reversible Bilateral Sensory Neural Hearing Loss Without Systemic Vasculitis: A Case Report and Review of Literature

Propylthiouracil (PTU) is a thioamide drug used in the management of hyperthyroidism in selected clinical settings. While PTU is associated with well-known adverse effects such as hepatotoxicity, agranulocytosis, and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, ototoxicity is an exceptionally rare complication....

Continue reading at PubMed →

Clinicians should consider PTU as a potential cause of sudden bilateral sensorineural hearing loss (unexplained hearing loss in both ears) even without systemic vasculitis (blood vessel inflammation), and prompt drug cessation may lead to hearing recovery.

This case expands the documented spectrum of PTU-related hearing damage (ototoxicity), highlighting a seronegative presentation that may be missed without a high index of clinical suspicion.

1. 01PTU (Propylthiouracil), an anti-thyroid medication, caused reversible bilateral sensorineural hearing loss in this patient.
2. 02Crucially, the case was seronegative — standard blood markers for vasculitis were absent, making diagnosis harder.
3. 03Hearing recovered after PTU was discontinued, suggesting prompt drug cessation is key.
4. 04No systemic vasculitis (widespread blood vessel inflammation) was present, distinguishing this from typical PTU-ANCA-associated cases.
5. 05A literature review accompanies the case, contextualising prior reports of PTU-associated ototoxicity.

PMID

42960292

DOI

10.1002/ccr3.73722.

Journal

Clinical Case Reports

Publication type

case_report

Evidence level

4

Sample size

1

Population

Single patient with PTU-induced bilateral sensorineural hearing loss without systemic vasculitis

Intervention

Discontinuation of Propylthiouracil (PTU)