Cochrane syndrome
Introduction
Introduction to Kegan Syndrome Cogan syndrome, also known as interstitial keratitis-vertigo-neural deafness syndrome, was first reported by Mogan and BaumGartner (1934) and later by Cogan (1945) as an independent systemic disease. Its main features are: 1 non-syphilitic interstitial keratitis; 2 vertigo and other vestibular neurological symptoms; 3 severe bilateral neurological deafness; 4 systemic vasculitis, such as congestive heart failure, gastrointestinal bleeding. basic knowledge The proportion of illness: 0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: high blood pressure, splenomegaly, headache, tension headache, peripheral nerve injury
Cause
Cause of Cogan syndrome
(1) Causes of the disease
Some people have suggested vaccination, upper respiratory tract infection, poisoning, sarcoidosis, drug allergy, etc. According to autopsy results, the disease is vascular disease (polyarteritis, occlusive vasculitis, cardiovascular disease, etc.) And combined with kidney disease, belongs to the category of rheumatism.
(two) pathogenesis
The histological changes of this disease are similar to nodular polyarteritis. Microscopic examination shows vascular inflammatory changes. Vasculitis not only affects the myometrial artery, but also affects different sizes of veins. The affected blood vessels have lymphocytes and neutrophils. Cell infiltration, accompanied by focal degeneration, necrosis and varying degrees of fibrosis, endocardial myocardial visualization, endocardial mononuclear cells, neutrophil infiltration, myocardial and cardiac valves in patients with cardiac involvement Focal fibrin mucus-like changes.
Prevention
Coronary syndrome prevention
1. To prevent possible incentives, the room should not be too cold and humid, and the temperature should be appropriate.
2. Prevent infection, strengthen exercise, enhance physical fitness, improve autoimmune function and regular life.
Complication
Complications of the stem syndrome Complications, hypertension, spleen, headache, tension, headache, peripheral nerve injury
About 1/4 of the patients have joint muscle involvement, which is muscle pain, arthritis or joint pain. About 1/l0 patients have high blood pressure, which may be caused by renal artery involvement. Some patients may have systemic lymphadenopathy. Large, splenomegaly, individual patients may have cerebral artery occlusion, manifested as varying degrees of hemiplegia, headache, language dyskinesia, cranial nerve palsy, peripheral nerve injury manifested as asymmetrical peripheral neuritis.
Symptom
Symptoms of Cognac Syndrome Common Symptoms Eye pain Abdominal discomfort Diarrhea Nausea Hearing Loss Eyes Foreign body edema Inability to congestion Panic
More frequent onset, some patients with respiratory infections as prodromal symptoms, and some patients with polyarthritis or polyarthritis as the main symptoms, and some patients with unexplained fever accompanied by rash as the first symptom, some patients Sudden deafness with early eye abnormalities is an early manifestation. Systemic symptoms include general discomfort, fatigue, loss of appetite and insomnia.
Eye symptoms
There are eye pain, shame, vision loss, foreign body sensation in the eye, etc., examination shows that the ciliary body is congested, there is granular conjunctival infiltration, grayish yellow, spotted, with the posterior half of the cornea, the boundary between infiltrates Clear, late in the course of the disease, the cornea may have new blood vessels, mostly bilateral, normal fundus, under the slit lamp, the cornea is like cholin-like crystal, flashing infiltration.
2. The eighth pair of cranial nerve symptoms
After several weeks to several months of ocular symptoms, cochlear symptoms, tinnitus, hearing loss, and auditory hearing may occur. Both are bilateral. The vestibular nerve symptoms may have dizziness, nausea, vomiting, and restlessness. There is rotatory vertigo.
3. Circulatory system
About 1/10 of patients may have aortic regurgitation, no obvious symptoms in the early stage, only obvious diastolic murmurs are heard in the aortic valve area during physical examination. As the disease progresses, symptoms of heart failure may occur. It is characterized by palpitation, shortness of breath, and edema of the lower extremities.
4. Digestive system
Some patients may have abdominal discomfort. In severe cases, stomach and colon ulcers may occur. Gastrointestinal ulcers are caused by mucosal vasculitis, sometimes causing upper or lower gastrointestinal bleeding. Individual patients present with unexplained diarrhea.
Examine
Examination of the stem syndrome
1. Blood routine and blood sedimentation
Most patients have mild to moderate leukocytosis, about one-third of patients have eosinophilia, almost all patients have increased erythrocyte sedimentation rate, and some patients have increased reticulocytes and thrombocytopenia.
2. Immunological examination
A small number of patients with rheumatoid factor, lupus cell positive, immunoglobulin and cellular immune test more normal.
X-ray chest radiograph shows left heart enlargement, whole heart enlargement, sometimes heart failure changes, ECG examination can find left heart hypertrophy, myocarditis, arrhythmia, a few patients may have EMG abnormalities, gastroscopy or sigmoidoscopy can find ulcers Sexual change.
Diagnosis
Diagnosis and diagnosis of stem syndrome
diagnosis
After the occurrence of specific eye abnormalities, the eighth pair of cranial nerve symptoms occurs again, and the diagnosis is not difficult.
Differential diagnosis
1. The disease needs to be differentiated from systemic lupus erythematosus, which has characteristic skin lesions, positive serum antinuclear antibody test, and Sm antibody, which is easier to distinguish.
2. When rheumatoid arthritis has ocular symptoms and the eighth pair of cranial nerve dysfunction, it is also easy to be confused with this disease, but rheumatoid arthritis has severe joint symptoms and many deformities, rheumatoid factor test. Positive, anti-nuclear antibodies are also mostly negative, the identification of the two is not difficult.
