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Acute Limb Ischemia in Cogan Syndrome
1Department of Emergency Medicine, Mayo Clinic, Jacksonville, FL, USA.
The American Journal of Case Reports
|April 30, 2022
Summary
Cogan syndrome, a rare autoimmune disorder, can cause severe systemic vasculitis. This case highlights acute limb ischemia as a rare but serious complication requiring emergent intervention.
Area of Science:
- Rheumatology
- Vascular Surgery
- Ophthalmology
Background:
- Cogan syndrome is a rare autoimmune disorder typically affecting ocular, vestibular, and auditory systems via small vessel vasculitis.
- Systemic manifestations, including gastrointestinal, neurologic, and musculoskeletal, can occur.
- Large-vessel involvement, such as aortitis, is less common, and acute limb ischemia is infrequently reported.
Observation:
- A 50-year-old male with a history of Cogan syndrome presented with acute left upper extremity ischemia.
- Physical examination revealed pallor and pulselessness in the left arm.
- CT angiography indicated vasculitis and embolic occlusion in the left upper limb arteries.
Findings:
- The patient received high-dose steroids, anticoagulants, and topical nitroglycerin.
- Significant clinical improvement was observed following treatment.
- This case illustrates Cogan syndrome presenting with severe systemic vasculitis leading to acute limb ischemia.
Implications:
- Treatment for severe Cogan syndrome depends on organ involvement and disease extent.
- Acute limb ischemia is a critical vascular complication of Cogan syndrome.
- Prompt diagnosis and emergent interventions, including imaging and anticoagulation, are vital to prevent limb-threatening outcomes.
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