title: Sudden hearing loss and Crohn disease: when Cogan syndrome must be suspected.
abstract: Cogan's syndrome is a rare systemic vasculitis of unknown origin. It is characterized by the presence of worsening audiovestibular and ocular symptoms that may manifest simultaneously or sequentially. No specific diagnostic laboratory tests or imaging studies exist. The diagnosis is clinical and should be established as early as possible so as to initiate prompt treatment with steroids and prevent rapid progression to deafness or blindness and potentially fatal systemic involvement. We report a case of association between Cogan's syndrome and ileal Crohn's disease which we believe deserves attention since, after an accurate review of the literature, we have found approximately 250 reports of patients with Cogan's syndrome, only 13 of whom with concurrent chronic inflammatory bowel disease; of these 13 cases, none experienced improvement after therapy. In the light of the good outcome obtained in our case, we proposed a valid treatment option with boluses of steroids, combined with early systemic immunosuppression and intra-tympanic steroid injections.
authors.affiliation: Department of Otorhinolaryngology, Cattinara Hospital, University Medical Center of Trieste, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Tirelli
authors.affiliation: Internal Medicine Department, Rheumatology Out-patients Unit, Cattinara Hospital, University Medical Center of Trieste, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Tomietto
authors.affiliation: Department of Otorhinolaryngology, Cattinara Hospital, University Medical Center of Trieste, Italy. Electronic address: quatela.eliana@gmail.com.
authors.forename: Eliana
authors.initials: E
authors.lastname: Quatela
authors.affiliation: Department of Otorhinolaryngology, Cattinara Hospital, University Medical Center of Trieste, Italy.
authors.forename: Fiorella
authors.initials: F
authors.lastname: Perrino
authors.affiliation: Department of Otorhinolaryngology, Cattinara Hospital, University Medical Center of Trieste, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Nicastro
authors.affiliation: Internal Medicine Department, Cattinara Hospital, University Medical Center of Trieste, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Cattin
authors.affiliation: Internal Medicine Department, Cattinara Hospital, University Medical Center of Trieste, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Carretta
mesh_terms: D001072:Apraxias / Q000150:complications / Q000151:congenital* / Q000175:diagnosis / Q000188:drug therapy; D001299:Audiometry; D055952:Cogan Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003937:Diagnosis, Differential; D004584:Electronystagmography; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003639:Hearing Loss, Sudden / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007267:Injections; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D014432:Tympanic Membrane; D055815:Young Adult
chemical_list: D005938:Glucocorticoids