[Uveitis, loss of hearing and vertigo after placement of a chitosan tamponade for postpartum hemorrhage-Postpartum Cogan syndrome].

This case series reports on three female patients who developed the clinical symptoms of Cogan syndrome (ocular and audiovestibular syndrome) in temporal association with postpartum hemorrhage and successful hemostasis using a chitosan tamponade. All three patients showed the constellation of symptoms typical for Cogan syndrome, i.e., interstitial keratitis, (pan)uveitis, vertigo and loss of hearing. Headaches were also present. In the reported cases the uveitis rapidly improved under local and systemic steroid treatment but the audiovestibular symptoms and cephalgia showed a delayed response. The temporal association and consistent symptom complex are suggestive of a possible association with the preceding childbirth and the chitosan tamponade. Against this background, a chitosan tamponade should be avoided, when possible from an obstetric perspective, and when one has been used a possible association to the described disease picture should always be considered. Affected patients should receive interdisciplinary care at an early stage by including ophthalmology, obstetrics, otorhinolaryngology and rheumatology.