Ann Rehabil Med.  2013 Apr;37(2):295-299. 10.5535/arm.2013.37.2.295.

Lofgren's Syndrome-Acute Onset Sarcoidosis and Polyarthralgia: A Case Report

• Byun CW
• Yang SN
• Yoon JS
• Kim SH

• KMID: 2165786
• DOI: http://doi.org/10.5535/arm.2013.37.2.295

Abstract

Lofgren's syndrome is an acute form of sarcoidosis characterized by erythema nodosum, bilateral hilar lymphadenopathy (BHL), and polyarthralgia or polyarthritis. This syndrome is common among Caucasians but rare in the Korean population. A 44-year-old woman was admitted to our hospital complaining of polyarthralgia. A chest radiograph revealed BHL and nodular shadows. Angiotensin-converting enzyme levels were within the normal range. Tissue biopsy from a mediastinum lymph node showed noncaseating granulomas. We diagnosed her with Lofgren's syndrome, an acute form of sarcoidosis.

Keyword

Sarcoidosis; Arthritis; Lymph node

MeSH Terms

Arthralgia
Arthritis
Biopsy
Erythema Nodosum
Female
Granuloma
Humans
Lymph Nodes
Lymphatic Diseases
Mediastinum
Reference Values
Sarcoidosis
Thorax

Figure

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  Fig. 1 Simple radiography of (A) bilateral hands, (B) knees, (C) ankles, and (D) hip showed periarticular osteoporosis. There is no swelling or any other abnormal findings.

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  Fig. 2 (A) Simple chest radiography showed mediastinal widening in both hila and in the upper right trachea (arrows). (B) Chest computerized tomography showed multiple enlarged lymph nodes in the mediastinum and in both hilar areas (arrows).

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  Fig. 3 Bone scintigraphy showed mildly increased uptakes in bilateral hands, wrist, shoulders, and small joint areas.

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  Fig. 4 A biopsied mediastinal lymph node treated using hematoxylin and eosin stain showed noncaseating granuloma of epithelioid cells with multinucleated giant cells (A, ×40; B, ×400).

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