ARTHRALGIA IN A YOUNG PATIENT: PRESENTATION OF LOFGREN SYNDROME
Abstract1Department of Medicine, 2Department of Orthopedics, Khyber Teaching Hospital, Peshawar-Pakistan Lofgren syndrome an acute form of sarcoidosis constitutes erythema nodosum, bilateral hilar adenopathy and arthralgia or arthritis. Here we present a case of a 28 years old young male patient who is a shopkeeper and farmer by profession admitted to inpatient department with chief complaints of bilateral painful nodules on his shins, low grade fever and pain multiple joints on both sides of the body. Suspicion of the Lofgren syndrome was made upon initial evaluation and patient was admitted to inpatient care facility for necessary comprehensive workup. Radiological findings were consistent with bilateral hilar lymphadenopathy and patient was diagnosed with Lofgren syndrome. Patient was started on non-steroidal inflammatory drugs (NSAIDs) with close observation for improvement in response to treatment. After one weak of treatment in hospital, patient was discharged home when his symptoms started to resolve.
Oshima M, Maeda H, Furonaka O, Doi M, Nishizaka T, Kuwabara M. Sarcoidosis with multiple organ involvement emerging as Löfgren's syndrome. Intern Med 2003;42(6):534–7.
Jansen T, Geusens P. Sarcoidosis: joint, muscle and bone involvement. Eur Respir Monogr 2005;32:210.
Alar T, Gunes F, MuratlÊ A, Gedik IE, Tekeli Z, Ukinc K. Löfgren's syndrome: an acute variant of sarcoidosis diagnosed by mediastinoscopy. J Coll Physicians Surg Pak 2015;25(2):146–8.
Nunes H, Bouvry D, Soler P, Valeyre D. Sarcoidosis. Orphanet J Rare Dis 2007;19:2:46.
Byun CW, Yang SN, Yoon JS, Kim SH. Lofgren's Syndrome-Acute Onset Sarcoidosis and Polyarthralgia: A Case Report Ann Rehabil Med 2013;37(2):295–9.
Saltman AP, Kuriya B. Löfgren syndrome in acute sarcoidosis. CMAJ 2017;189(39):E1230.
Mañá J, Gómez-Vaquero C, Salazar A, Valverde J, Juanola X, Pujol R. Periarticular ankle sarcoidosis: a variant of Löfgren’s syndrome. J Rheumatol 1997;24(1):239.
Lofgren S, Lundback H. The bilateral hilar lymphoma syndrome; a study of the relation to tuberculosis and sarcoidosis in 212 cases. Acta Med Scand 1952;142:265–73.
Kumar G, Kumar N. All red is not always bacterial cellulitis: a case of Löfgren's syndrome. WMJ 2010;109(1):31–3.
García-Porrúa C, González-Gay MA, Vázquez-Caruncho M, López-Lazaro L, Lueiro M, Fernández ML, et al. Erythema nodosum: etiologic and predictive factors in a defined population. Arthritis Rheum 2000;43(3):584–92.
Ohta H, Tazawa R, Nakamura A, Kimura Y, Maemondo M, Kikuchi T, et al. Acute-onset sarcoidosis with erythema nodosum and polyarthralgia (Löfgren's syndrome) in Japan: a case report and a review of the literature. Intern Med 2006;45(9):659–62.