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Lofgren Syndrome — SCE Rheumatology MCQ

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ModerateConnective Tissue DiseaseLofgren SyndromeSCE Rheumatology

A 45-year-old man presents with acute bilateral ankle arthritis and tender erythematous nodules over both shins. Chest radiography shows symmetrical bilateral hilar lymphadenopathy. Which syndrome best describes this presentation?

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Correct answer: A — Löfgren syndrome

This is Löfgren syndrome, an acute sarcoid phenotype characterised by bilateral hilar lymphadenopathy, erythema nodosum and acute ankle-predominant arthritis or periarticular inflammation. It usually has a self-limiting course and favourable prognosis. Heerfordt syndrome is another sarcoid phenotype but features uveitis, parotid enlargement, fever and sometimes facial nerve palsy. Jaccoud arthropathy is a reducible, deforming, usually non-erosive arthropathy associated particularly with systemic lupus erythematosus. Mikulicz syndrome describes bilateral lacrimal and salivary gland enlargement. Blau syndrome is a childhood-onset granulomatous disorder characterised by dermatitis, arthritis and uveitis.

Reference: Day J, Hamann PDH. Rheumatic Manifestations of Sarcoidosis. Diagnostics. 2024;14:2842. https://pubmed.ncbi.nlm.nih.gov/24855899/