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A case of Cogan syndrome with atypical ocular symptoms Haruka Ueda 1,2 , Takaaki Matsuki 1,3 , Ken Watanabe 1,3 , Kunihiko Akiyama 1,3 , Toru Noda 1,3 1Department of Ophthalmology, National Hospital Organization Tokyo Medical Center 2Department of Ophthalmology, Keiyu Hospital 3National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center pp.613-617
Published Date 2023/5/15
DOI https://doi.org/10.11477/mf.1410214795
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Abstract Purpose:To report a case of Cogan syndrome with atypical ocular symptoms.

Subject:A man in his 60s.

Observations:The patient complained of bilateral eye redness recalcitrant to a topical corticosteroid from 2 months prior. He also complained of headache, shoulder stiffness, and tinnitus. His visual acuity and visual field were normal. Slit-lamp biomicroscopy showed episcleritis, mild iritis, optic disc redness, and swelling. Fluorescein angiography showed a mild leakage from the optic disc without any leakage from vessels. Laboratory studies showed elevated levels of erythrocyte sedimentation and C-reactive protein. Positron emission tomography and computed tomography showed pathological uptake in the aorta ascendens and abdomen. An audiometric test showed mild hearing loss in his left ear. The patient was diagnosed with Cogan syndrome and administered systemic corticosteroid at a high dose. The patient's ocular and systemic symptoms subsequently regressed.

Conclusions:Cogan syndrome typically presents with interstitial keratitis;however, episcleritis could be the only sign. Cogan syndrome should be included as a differential diagnosis of a patient with refractory ocular inflammation with vestibulo-auditory and systemic signs.


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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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