• Misako Higashida-Konishi, Mitsuhiro Akiyama, Hiroki Tabata, Satoshi Hama, Tatsuhiro Oshige, Keisuke Izumi, Hisaji Oshima, and Yutaka Okano.
• Division of Rheumatology, Department of Medicine, National Hospital Organization Tokyo Medical Center, Japan.
• Intern. Med. 2023 Nov 15; 62 (22): 341334173413-3417.

AbstractA 61-year-old man presented with weight loss, bilateral ocular redness, blurred vision, and sensorineural hearing loss. Fluorodeoxyglucose-position emission tomography/computed tomography demonstrated an uptake in the ascending and descending aorta, abdominal aorta and femoral arteries. Atypical Cogan's syndrome complicated with large-vessel vasculitis (LVV) was diagnosed. He was treated with high-dose prednisolone and subcutaneous tocilizumab (162 mg/week), resulting in successful improvements in his ocular and vascular involvements. Although there is currently no established treatment strategy for LVV associated with Cogan's syndrome, our case and literature review suggest that tocilizumab is a viable treatment option for this rare but life-threatening complication.

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