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Pulmonary sarcoidosis — SCE Respiratory MCQ

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ModerateILDPulmonary sarcoidosisSCE Respiratory

A 35-year-old woman with erythema nodosum and ankle arthralgia has cough and fatigue. CXR shows bilateral hilar lymphadenopathy; serum calcium is 2.73 mmol/L and ACE is raised. She has no visual symptoms and spirometry is normal. What is the most likely diagnosis?

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Correct answer: C — Löfgren syndrome due to acute sarcoidosis

Erythema nodosum, ankle arthralgia and bilateral hilar lymphadenopathy form the classic Löfgren syndrome presentation of acute sarcoidosis. TB and lung cancer are important differentials but the acute periarthritis and erythema nodosum pattern is more characteristic here. Hypersensitivity pneumonitis and EGPA do not usually present with this triad.

Reference: BTS Clinical Statement on Pulmonary Sarcoidosis