CD40LG and otosclerosis: Further, CD46 levels were positive only in 3.3% of otosclerosis cases in a British cohort [4], and Singh et al. [13] reported that otosclerosis is not commonly associated with systemic viral infections, such as measles, rubella, human cytomegalovirus, herpes simplex, varicella zoster, and Epstein–Barr virus by testing their IgM antibodies.