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非典型科根综合征:一例病例报告及当前治疗选择概述

Atypical Cogan's syndrome: a case report and summary of current treatment options.

作者信息

Jančatová Debora, Zeleník Karol, Komínek Pavel, Matoušek Petr

机构信息

Department of Otorhinolaryngology, University Hospital Ostrava, 17 listopadu 1790, 708 52 Ostrava, Czech Republic.

Department of Otorhinolaryngology, University Hospital Ostrava, 17 listopadu 1790, 708 52 Ostrava, Czech Republic; Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic.

出版信息

Int J Pediatr Otorhinolaryngol. 2015 Mar;79(3):428-31. doi: 10.1016/j.ijporl.2014.12.028. Epub 2015 Jan 3.

Abstract

Cogan's syndrome is a rare chronic vasculitis, characterized in its typical form by progressive sensorineural bilateral hearing loss, vestibular symptoms and non-syphilitic interstitial keratitis. Only a few cases have been reported in children, most of whom have been diagnosed with the typical form. Early diagnosis and treatment are crucial to ensure a favorable prognosis. Systemic treatment usually begins with high dosage corticosteroids. In case the initial treatment fails, other immunosuppressive drugs are used (cyclophosphamide, methotrexate, cyclosporine A and azathioprine). Additional treatment possibilities, such as plasmapheresis, TNF-alpha blockers (etanercept and infliximab), rituximab, tocilizumab and mycophenolate mofetil have been described over the past few years.

摘要

科根综合征是一种罕见的慢性血管炎,其典型形式的特征为进行性双侧感音神经性听力丧失、前庭症状和非梅毒性间质性角膜炎。儿童中仅报道了少数病例,其中大多数被诊断为典型形式。早期诊断和治疗对于确保良好预后至关重要。全身治疗通常始于高剂量皮质类固醇。如果初始治疗失败,则使用其他免疫抑制药物(环磷酰胺、甲氨蝶呤、环孢素A和硫唑嘌呤)。在过去几年中,还描述了其他治疗可能性,如血浆置换、肿瘤坏死因子-α阻滞剂(依那西普和英夫利昔单抗)、利妥昔单抗、托珠单抗和霉酚酸酯。

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