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Sarcoidosis (Löfgren Syndrome) — RACP Adult Medicine MCQ

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ModerateRespiratorySarcoidosis (Löfgren Syndrome)RACP Adult Medicine

A 50-year-old woman presents with cough and dyspnoea. She has bilateral erythema nodosum on the shins and bilateral ankle arthralgia. CXR shows bilateral hilar lymphadenopathy with bilateral pulmonary infiltrates. ACE is elevated. What is the most likely diagnosis?

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Correct answer: C — Sarcoidosis

BHL with pulmonary infiltrates (Stage II sarcoidosis), erythema nodosum, and bilateral ankle arthralgia constitutes Löfgren syndrome — an acute presentation of sarcoidosis with excellent prognosis (>90% spontaneous resolution). Elevated ACE supports the diagnosis. Treatment is NSAIDs for symptoms; systemic corticosteroids only if progressive or organ-threatening disease.

Reference: BTS – 2020 – Sarcoidosis Guidelines; eTG Respiratory 2024