Löfgren Syndrome: Clinical Presentation, Clinical Course, and Literature Review

Abstract

Löfgren syndrome is an acute presentation of sarcoidosis that comprises fever, bilateral and symmetric hilar lymphadenopathies, polyarthritis, and erythema.We present the case of a 34-year-old male patient who presented with ankle monoarthritis without a history of a traumatic event. Contralateral ankle arthritis associated with erythema nodosum and fever developed one week later. Laboratory tests showed anemia, thrombocytosis, and elevated inflammatory parameters. A chest CT revealed symmetrical mediastinal and hilar adenopathies. A transbronchial biopsy was compatible with granulomatous lymphadenitis, and the diagnosis of Löfgren syndrome was confirmed.Our case report and literature review emphasize the wide web of mimicry of acute sarcoidosis. Secondary forms of acute sarcoidosis are likely to benefit from additional and more complex immunomodulatory therapies. Close monitoring and follow-up should be conducted because it is possible that these patients experience higher rates of recurrence or relapse.

Lofgren Syndrome: Achieving an Accurate Diagnosis for Improved Patient Care

“…Sarcoidosis, particularly Lofgren syndrome, can encompass numerous different clinical presentations [ 6 ]. The clinical course of sarcoidosis is variable and sometimes unpredictable, ranging from acute and self-limited to chronic, progressive, and debilitating, whereas, with Lofgren syndrome, the symptoms usually reverse without medication [ 3 ]. The most commonly affected organs are the lungs, although a proportion of patients show extrapulmonary involvement such as the skin, lymph nodes, and eyes [ 3 ].…”

“…The clinical course of sarcoidosis is variable and sometimes unpredictable, ranging from acute and self-limited to chronic, progressive, and debilitating, whereas, with Lofgren syndrome, the symptoms usually reverse without medication [ 3 ]. The most commonly affected organs are the lungs, although a proportion of patients show extrapulmonary involvement such as the skin, lymph nodes, and eyes [ 3 ]. A diagnosis of Lofgren syndrome is accepted when compatible clinical and radiological findings are present.…”

“…The onset is acute, unlike sarcoidosis, which is more insidious and has slower progression. Ninety-five percent of cases with this condition present benign pathology without sequelae and without treatment, although some cases may require immunosuppression to achieve complete remission [ 3 , 4 ]. The diagnosis is based on clinical, imaging data, and histological findings, with the already specified triad having high sensitivity and specificity [ 5 ].…”

Sarcoidosis revealed by long-term fever at the Vierzon Hospital: About a case and literature review

“…Sedimentation rate and C-reactive protein are mostly normal as reported in the present study. Löfgren's syndrome is an acute manifestation of sarcoidosis that combines fever, hilar and mediastinal adenopathy, polyarthritis and erythema nodosum with inflammatory biological signs [15]. Angiotensin-1 converting enzyme is elevated in only 50% of sarcoidosis cases [3,13].…”

The Association Between Lung Cancer and Sarcoidosis: A Literature Review

“…To diagnose sarcoidosis, doctors rely on three criteria: a clinical and radiologic presentation consistent with the disease, pathologic evidence of non-caseating granulomas, and excluding other diseases with similar findings, such as infections or malignancy [ 8 ]. A clinically distinct phenotype of sarcoidosis, Lofgren syndrome, typically presents acutely in younger patients with acute onset erythema nodosum (EN), bilateral hilar lymphadenopathy, fever, and migratory polyarthritis, and without granulomatous skin involvement [ 9 ].…”