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

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  • Hara Kazusato
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Umeda Masataka
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan Medical Education Development Center, Nagasaki University Hospital, Japan Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Segawa Keiko
    Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Akagi Midori
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Endo Yushiro
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Koga Tomohiro
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Kawashiri Shin-ya
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Ichinose Kunihiro
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Nakamura Hideki
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Maeda Takahiro
    Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Kawakami Atsushi
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan

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抄録

<p>A 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. </p>

収録刊行物

  • Internal Medicine

    Internal Medicine 61 (8), 1265-1270, 2022-04-15

    一般社団法人 日本内科学会

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