Possible link between Cogan’s syndrome and IBD highlighted
MedWire News: Patients with inflammatory bowel disease (IBD) may be at increased risk for developing Cogan's syndrome (CS), say researchers.
CS is a rare autoimmune disease that mostly affects the audiovestibular system and the eyes, and can result in deafness.
Co-existing IBD and CS has previously been observed in a small number of patients. Stephan Vavricka (University Hospital Zurich, Switzerland) and colleagues describe four further cases of patients with IBD who developed CS - three women with ulcerative colitis (UC) and one man with Crohn's disease (CD).
The three women with UC had a long duration of intestinal disease before developing CS and all four IBD patients had a complicated IBD disease course. The three women were aged 17, 36, and 44 years on diagnosis with UC and were aged 39, 40, and 51, respectively, on CS diagnosis. The man was diagnosed with CD at age 26 years and with CS a year later.
The patients developed sudden CS-related symptoms such as interstitial keratitis (n=3), scleritis (n=2), bilateral hearing loss (n=4), or loss or impairment of equilibrium sense (n=4), and three (two UC, one CD) went completely deaf a few years after being diagnosed with CS.
All four patients were taking immunosuppressive IBD therapy, but this appeared to have no effect on the onset of CS.
Around 250 cases of CS have been reported in the literature to date. Vavricka et al comment: "Given the low overall number of reported cases for CS in literature, our four cases represent a significant contribution to this disease and may put the focus on a possible pathophysiological association between IBD and CS."
The authors suggest: "Since CS rapidly leads to complete deafness, one must carefully consider the diagnosis of CS in every IBD patient reporting symptoms such as dizziness, hearing loss, tinnitus or visual problems."
The results of this study are reported in the Journal of Crohn's and Colitis.
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By Helen Albert