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科根综合征:两家三级医院诊断和治疗的 7 例病例描述性分析和临床经验。

Cogan syndrome: Descriptive analysis and clinical experience of 7 cases diagnosed and treated in two third level hospitals.

机构信息

Servicio de Reumatología, Hospital Universitario 12 de Octubre, Madrid, España.

Servicio de Reumatología, Hospital Universitario 12 de Octubre, Madrid, España.

出版信息

Reumatol Clin (Engl Ed). 2021 Jun-Jul;17(6):318-321. doi: 10.1016/j.reuma.2019.11.008. Epub 2020 Jun 19.

Abstract

OBJECTIVE

Cogan's syndrome (CS) is an inflammatory disease classified as variable vessel vasculitis. It is a rare disease with few published series, and therefore we reviewed our experience in the last ten years in two centres.

MATERIALS AND METHODS

Description of 7 diagnosed cases of CS, according to the classification criteria (typical or atypical), their clinical manifestations, treatments used and their complications. A comparative analysis was performed with the series and cases described in the literature.

RESULTS

Seven cases were included, three men and four women, with a mean age at diagnosis of 43 years, and an average disease duration of 47 months. Five patients met the typical characteristics according to the 1980 classical criteria, the rest being atypical cases, one due to the absence of interstitial keratitis and another due to a period between the onset of ocular and auditory-vestibular clinical symptoms greater than two years. All received immunosuppressants, methotrexate being the most commonly used, followed by azathioprine. In 5 cases, biological drugs were used, infliximab in 4 times and 2 tocilizumab. One patient died from bacterial endocarditis and septic shock.

CONCLUSION

The characteristics of the series presented are like those published to date, with clinical differences mainly in the involvement of large vessels. Given the low frequency, it seems necessary to create multicentre records to improve the evidence regarding the management of patients with CS.

摘要

目的

Cogan 综合征(CS)是一种分类为可变血管血管炎的炎症性疾病。它是一种罕见疾病,发表的系列研究较少,因此我们在两个中心回顾了过去十年的经验。

材料和方法

根据分类标准(典型或非典型)描述 7 例确诊的 CS 病例,描述其临床表现、使用的治疗方法及其并发症。与文献中描述的系列和病例进行了比较分析。

结果

共纳入 7 例患者,男 3 例,女 4 例,诊断时的平均年龄为 43 岁,平均病程为 47 个月。5 例患者符合 1980 年经典标准的典型特征,其余为非典型病例,1 例因缺乏间质性角膜炎,另 1 例因眼和听觉-前庭临床症状发作之间的时间超过两年。所有患者均接受了免疫抑制剂治疗,其中甲氨蝶呤最常用,其次是硫唑嘌呤。5 例患者使用了生物药物,4 次使用英夫利昔单抗,2 次使用托珠单抗。1 例患者死于细菌性心内膜炎和感染性休克。

结论

目前发表的系列研究的特点与以往的研究相似,主要在大血管受累方面存在临床差异。鉴于其发病率低,似乎有必要建立多中心记录,以提高关于 CS 患者管理的证据。

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