Mekinian A, Pouchot J, Zenone T, Fain O
Sorbonne Université, AP-HP, Hôpital Saint-Antoine, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DMU i3), 75012 Paris, France.
AP-HP, Université de Paris, Hôpital européen Georges Pompidou, Service de médecine interne, Paris, France.
Rev Med Interne. 2021 Apr;42(4):269-274. doi: 10.1016/j.revmed.2020.07.007. Epub 2020 Aug 7.
"Typical" Cogan's syndrome is defined as a non-syphilitic interstitial keratitis associated with audio-vestibular resembling Ménière's disease with a 2-year maximum delay between these 2 organ impairment. Cogan syndrome is classified as "atypical" in the absence of interstitial keratitis and the presence of other inflammatory eye manifestations, an audio-vestibular impairment different from typical Menière-like disease, or a delay longer than 2 years between eye and audio-vestibular manifestations. Constitutional signs and large-vessel vasculitis is also possible, mostly affecting the thoracic aorta. The presence of acute-phase reactants is common, but no specific laboratory tests are available. The prognosis is dominated by the audio-vestibular impairment and in particular the risk of deafness, while other complications especially vascular complications being rare. Treatment with glucocorticoids is usually necessary and the combination to other immunosuppressive therapies or biological-targeted drugs needs to be determined.
“典型”科根综合征的定义为非梅毒性间质性角膜炎,伴有类似梅尼埃病的听觉前庭症状,这两种器官损害之间的最长间隔为2年。在没有间质性角膜炎且存在其他眼部炎症表现、不同于典型梅尼埃样疾病的听觉前庭损害、或眼部与听觉前庭表现之间的间隔超过2年的情况下,科根综合征被归类为“非典型”。还可能出现全身症状和大血管血管炎,主要影响胸主动脉。急性期反应物常见,但没有特异性实验室检查。预后主要取决于听觉前庭损害,尤其是耳聋风险,而其他并发症尤其是血管并发症很少见。通常需要用糖皮质激素治疗,其他免疫抑制疗法或生物靶向药物的联合使用需要确定。