Inaugural description of Cogan syndrome in an HIV-infected person

摘要

Sirs: Cogan syndrome is an uncommon disease, characterized by non-syphilitic interstitial keratitis, and cochleovestibular manifestations. The latter look alike severe Meniere's disease and usually lead to deafness in 3 months. Almost 60% of the patients develop systemic manifestations, 10 % of them suffering from life-threatening complications such as a systemic necrotizing vasculitis. The physiopathogenesis of Cogan syndrome is likely autoimmune, possibly mediated by the humoral immune response.In July 2006, a 43 year-old woman known for HIV infectionfor 21 years, and hepatitis C, presented with three bouts of rotatory vertigo, emesis and left hearing loss. She was on antiretroviral treatment since 1992, and, since 2000 specifically on nevirapine, lamivudine, and zidovudine. Her CD4 count and HIV viral load were 616 cells/mm3 and undetectable, respectively. Suspecting Meniere's disease, she was placed on a one-week treatment of prednisone 40 mg daily.