The Presence of Heat Shock Protein 70 (HSP70) Antibodies in Bilateral Meniere’s Disease: A Case Report

Meniere's disease (MD) is a chronic, idiopathic inner ear disorder characterized by episodes of vertigo, fluctuating sensorineural hearing loss, tinnitus, aural fullness, gait disturbances, and postural instability. The pathophysiology is most commonly thought to be due to either an excess of endolymphatic fluid secretion or a failure to resorb the fluid into the subarachnoid space. The distension of the endolymphatic space disrupts the auditory and vestibular systems, leading to the symptoms experienced. Postulated causes of MD have been linked to allergies, genetic mutations, epigenetic factors, and alterations in anatomy, but an autoimmune cause is currently the strongest hypothesis. Specifically, the expansion of the endolymphatic space has been found to trigger the release of heat shock protein 70 (HSP70) antibodies, leading to MD. Although a causal link remains unconfirmed, these findings suggest an underlying autoinflammatory mechanism, warranting further investigation. We present a 29-year-old female who has bilateral MD, a rare finding in itself, in addition to being positive for HSP70 antibodies. This case underscores the importance of recognizing the potential autoimmune associations of MD, particularly in bilateral presentations, and contributes to the limited literature linking HSP70 antibodies to disease pathology and potential therapeutic targets.