Löfgren syndrome

Q: 27 year old male is admitted to ICU with fever, dehydration, hypotension, bilateral ankle arthritis. CXR showed hilar adenopathy. The resident on call put Löfgren syndrome in differential diagnosis despite no presence of erythema nodosum. He argues that male patients may not have erythema nodosum in Löfgren syndrome? (select one)  

A) True
B) False


Answer: A

Löfgren syndrome (acute sarcoidosis) is a cluster of symptoms in acute sarcoidosis, comprising of erythema nodosum (EN), hilar adenopathy, migratory polyarthralgia, and fever. All classic symptoms are usually present in women, and clinical features can be so overwhelming that diagnosis may not even require biopsy. Male patients with Löfgren syndrome usually present with signs of bilateral ankle arthritis, but without EN.

#rheumatology


References:

1. Grunewald J, Eklund A. Sex-specific manifestations of Löfgren's syndrome. Am J Respir Crit Care Med 2007; 175:40. 

2. O'Regan A, Berman JS. Sarcoidosis. Ann Intern Med 2012; 156:ITC5.