Cogan Syndrome — RACP Adult Medicine MCQ

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HardGeneral Internal MedicineCogan SyndromeRACP Adult Medicine

A 75-year-old woman presents with progressive bilateral sensorineural hearing loss, vertigo, and unsteady gait. She also has interstitial keratitis and arthralgia. Her ESR is 65 mm/hr and CRP is 45 mg/L. What is the most likely diagnosis?

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Correct answer: E — Cogan syndrome

Cogan syndrome is a rare autoimmune condition characterised by interstitial keratitis (or other ocular inflammation) and vestibuloauditory dysfunction (sensorineural hearing loss, vertigo). It may be associated with systemic vasculitis (including aortitis). Early treatment with systemic corticosteroids and immunosuppression is critical to prevent permanent hearing loss. TNF inhibitors or methotrexate are used as steroid-sparing agents.

Reference: eTG – 2025 – Rheumatology