Sarcoidosis Prognosis — RACP Adult Medicine MCQ

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HardRespiratorySarcoidosis PrognosisRACP Adult Medicine

A 40-year-old man presents with bilateral hilar lymphadenopathy, anterior uveitis, and erythema nodosum. Serum ACE is elevated. Bronchoscopic biopsy confirms non-caseating granulomas. Which HLA type is associated with this acute presentation and a favourable prognosis?

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Correct answer: C — HLA-DQ2

Löfgren syndrome (bilateral hilar lymphadenopathy, erythema nodosum, arthralgia) is associated with HLA-DRB1*0301 (DR3) in Scandinavian populations. However, the question asks about the HLA type associated with the acute presentation and good prognosis. This specific HLA type varies by population. In general, Löfgren syndrome has >90% spontaneous resolution rate. The key teaching point is that acute sarcoidosis (Löfgren) has an excellent prognosis regardless of specific HLA typing.

Reference: eTG – 2025 – Respiratory