Multidisciplinary unravelling Cogan’s syndrome post-C-section: insights into diagnosis, treatment and a possible identified new trigger

Abstract

We present a case series consisting of three female patients in their 30s with presumed autoimmune uveitis resembling Cogan’s syndrome following caesarean sections (C-sections) with severe intraoperative bleeding and the use of chitosan-tamponade, exhibiting a combination of varying ocular and auditory symptoms postoperatively. Our patients displayed a range of inflammatory ocular changes, including stromal keratitis, panuveitis, retinal infiltrates, haemorrhages, optic disc swelling, and intraretinal and subretinal fluid, along with otalgia and hearing loss, consistent with typical and atypical Cogan’s syndrome. Treatment involved systemic corticosteroids, resulting in variable outcomes. Given the rarity of this disease and its occurrence in similar circumstances, we investigated for a possible common trigger. Vigilance for ocular and auditory symptoms post-C-section, severe blood loss or after the use of chitosan is emphasised, and further research into potential triggers is warranted.