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Löfgren syndrome — SCE Respiratory MCQ

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EasyInterstitial lung diseaseLöfgren syndromeSCE Respiratory

A 31-year-old woman presents with fever, painful erythematous nodules over both shins and bilateral ankle swelling. Chest radiograph shows symmetrical bilateral hilar lymphadenopathy without parenchymal shadowing. Serum calcium is normal, ECG is normal and spirometry is preserved. She is otherwise well and symptoms are controlled with simple analgesia. What is the most appropriate management?

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Correct answer: B — Supportive treatment with non-steroidal anti-inflammatory drugs and follow-up

This is Löfgren syndrome, an acute sarcoidosis phenotype with erythema nodosum, ankle periarthritis and bilateral hilar lymphadenopathy, often self-limiting. Steroids are reserved for significant organ involvement or refractory symptoms rather than mild disease. The key clinical pearl is to look for cardiac, ocular, neurological and calcium complications before deciding on observation.

Reference: BTS Clinical Statement on Pulmonary Sarcoidosis; ERS sarcoidosis treatment guideline