Typical Cogan’s syndrome: report of a case

Background: Cogan’s syndrome is a rare entity of autoimmune origin. It is characterizedby non-syphilitic interstitial keratitis associated with audiovestibular symptomssimilar to Meniere’s syndrome. Early symptoms include eye redness and photophobia,which can be added conjunctivitis or uveitis.Objective: To report a case of typical Cogan’s syndrome and describe the main featuresof the entity.Case report: Male, 32, no morbid history. Consults for story of 4 days of evolutioncharacterized by eye pain and conjunctival injection. Initially diagnosed with sinusitisand acute conjunctivitis and handled as such. By persisting symptoms is hospitalizeda week later demonstrating fever, bilateral conjunctival injection and in a few dayshearing loss. Laboratory tests include leukocytosis, thrombocytosis, and elevatedPCR, VHS and IgA. Autoantibodies, HIV and HCV study were negative, brain and sinusesCT normal. Reviewed by ophthalmology and otolaryngology, describing conjunctivalhyperemia and chemosis, and sensorineural hearing loss of probable autoimmuneorigin, respectively. Evaluated by rheumatology, typical Cogan’s syndrome arises. It isindicated prednisone 1 mg/kg/day, methylprednisolone for 2 days and weekly methotrexate,with good response. Evolves with decreased in headache, eye commitmentand hearing loss, afebrile, was discharged with prednisone and methotrexate. Controla month after discharge, asymptomatic, treatment is maintained. Control 20 days laterin ophthalmology, objectifying mild corneal edema, so topical treatment indicated...