Clinical features and literature review of Cogan’s syndrome with bilateral internal carotid artery occlusion

Cogan’s syndrome is rare.The purpose of this article is to describe a Cogan’s syndrome case characterized by bilateral internal carotid artery occlusion and to review the literature.Treatment remedies:we showed a patient with vertigo,nausea and retching,blurred vision,unclear speech.And the whole cerebral angiogram of the patient showed bilateral internal carotid artery occlusion without obvious neurological deficit.After differential diagnosis,compared with classic Cogan’s syndrome,granulomatous polyvasculitis(GPA),rheumatoid arthritis(RA),systemic lupus erythematosus(SLE),the patient was considered as Cogan’s syndrome.Post treatment evaluating:the patient did not significantly improve vertigo after vascular bypass therapy.Conclusions:Cogan’s syndrome may cause severe vascular occlusion.The patient had no clinical symptoms;and the chronic occlusion caused by vascular inflammation may be the reason,so that there was enough time for compensation.

Undifferentiated Arthritis Revealing Cogan’s Disease

Background: Cogan’s syndrome is a rare autoimmune vasculitis (less than 300 cases described in the literature) characterized in its typical form by cochleovestibular involvement, interstitial keratitis, and an inflammatory involvement of large vessels. It is frequently accompanied by general signs and cardio-vascular, rheumatologic, and digestive complications. Its management is essentially based on the use of corticosteroids and immunosuppressants. The outcome of the treatment, even if rapid, does not always avoid functional complications. This disease is probably under-diagnosed in Africa. Objective: The objective of this study was to report a case of Cogan syndrome in sub-Saharan Africa. Case report: A 78 year old black African female patient presented with arthritis of the left knee without fever. The examination also revealed a bilateral deafness of rapidly progressive onset. The patient was known to be diabetic and hypertensive, and was regularly monitored. The biology revealed an inflammatory syndrome and an inflammatory joint puncture fluid. Pure tone audiometry confirmed a 77% hearing loss. The ophthalmological examination revealed stromal oedema and hypertensive retinopathy of Kendall stage III. The rheumatological evolution was good under methylprednisolone and methotrexate, but the deafness persisted. The occurrence of a fever on day 12 of treatment required further investigations (blood culture, PCR-Covid 19 test, cytobacteriological examination of sputum, thoracic CT). The evolution was unfavourable with the death of the patient. Conclusion: Cogan’s disease is a rare inflammatory disease. Its diagnosis and management are multidisciplinary. The treatment can be disappointing.

Atypical Cogan＇s syndrome associated with coronary disease

Cogan＇s syndrome （CS） is a rare inflammatory disorder characterized by interstitial keratitis and vestibuloauditory abnormalities often associated with various systemic manifestations. Involvement of cardiovascular system resembling systemic vasculitis may lead to severe complications and death. The present report describes a case of a female patient with atypical Cogan＇s syndrome presented with systemic manifestations and severe coronary and femoral artery stenosis Despite the clinical improvement after glucocorticoids and cyclophosphamide, the patient required double aortocoronal bypass grafting one year letter. During three years follow-up, she was in stable condition, without stenocardial symptoms and claudication and her inflammatory parameters remain normal. This case highlights the rare involvement of coronary arteries without associated large-vessel vasculitis of the aortic arch in CS.