• Internal medicine · Apr 2022

    Case Reports

    Atypical Cogan's Syndrome Mimicking Giant Cell Arteritis Successfully Treated with Early Administration of Tocilizumab.

    • Kazusato Hara, Masataka Umeda, Keiko Segawa, Midori Akagi, Yushiro Endo, Tomohiro Koga, Shin-Ya Kawashiri, Kunihiro Ichinose, Hideki Nakamura, Takahiro Maeda, and Atsushi Kawakami.
    • Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan.
    • Intern. Med. 2022 Apr 15; 61 (8): 1265-1270.

    AbstractA 49-year-old Japanese man with a 2-month history of a fever, headache, and bilateral conjunctival hyperemia was admitted. His condition fulfilled the giant cell arteritis classification criteria (new headache, temporal artery tenderness, elevated ESR) and atypical Cogan's syndrome (CS) with scleritis and sensorineural hearing loss (SNHL). The interleukin (IL)-6 serum level was extremely high. Two weeks after his insufficient response of SNHL and scleritis to oral prednisolone, we administered tocilizumab (TCZ); rapid improvements in scleritis and SNHL occurred. Early IL-6 target therapy can help prevent irreversible CS-induced sensory organ damage.

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