Lofgren's síndrome as a rare form of acute sarcoidosis
Keywords:
SARCOIDOSIS, GRANULOMATOUS DISEASE, ERYTHEMA NODOSUM, AUTOIMMUNE DISEASES.Abstract
Introduction: sarcoidosis is a granulomatous and multisystemic disease of unknown etiology defined as an inflammatory response to an environmental antigen in a genetically susceptible person. Löfgren's syndrome is a form of presentation with stereotypical clinical findings manifested as a triad of acute periarthritis, erythema nodosum and hilar adenopathy.
Case report: we report a case with the characteristic findings of this clinical form in which, after the multidisciplinary discussion of the findings found in the physical examination and complementary studies, it was decided to start treatment with glucocorticoids without performing mediastinal lymph node biopsy, an invasive and risky procedure.
Conclusions: the clinical evolution of the patient was favorable and at present he is asymptomatic, without treatment and without evidence of complications or progression towards the chronic form of the disease after three years of evolution.
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1. Jain R, Yadav D, Puranik N, Guleria R, Jin JO. Sarcoidosis: Causes, Diagnosis, Clinical Features, and Treatments. J Clin Med[Internet]. 2020[Citado 20/05/2023]; 9(4):1081. Disponible en: https://doi.org/10.3390/jcm9041081
2. Martínez RW, Gil LG, Forteza TO, Borrajero MI. Sarcoidosis esplénica. Presentación de un caso. Breve revisión de la literatura. Revista Electrónica de Autopsia[Internet].2011[Citado 20/05/2023]; 9:1 aprox. 11p. Disponible en:https://journaldatabase.info/articles/sarcoidosis_esplenica_presentacion_un.html
3. Crouser ED, Maier LA, Wilson KC, et al. Diagnosis and Detection of Sarcoidosis. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med[Internet]. 2020[Citado 20/05/2023]; 201(8):e26-e51. Disponible en: https://doi.org/10.1164/rccm.202002-0251ST
4. Brown F, Modi P, Tanner LS. Lofgren Syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing[Internet]; 2021[Citado 20/05/2023]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29493940
5. Polverino F, Balestro E, Spagnolo P. Clinical Presentations, Pathogenesis, and Therapy of Sarcoidosis: State of the Art. J Clin Med[Internet]. 2020[Citado 20/05/2023]; 9(8):2363. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32722050/
6. Fu Y, Chen Q, Yu Z, et al. Clinical application of ultrasound-guided mediastinal lymph node biopsy through cervical mediastinoscopy. Thorac Cancer[Internet]. 2021[Citado 20/05/2023];12(3):297-303. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862788/
7. Tol SJM, van der Zant FM, Knol RJJ, Wondergem M, Broos WAM. Löfgren Syndrome on 18F-FDG PET/CT: An Acute Manifestation of Sarcoidosis. Clin Nucl Med[Internet]. 2022[Citado 20/05/2023]; 47(1): 61-62. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34874349/
8. Gerke AK. Treatment of Sarcoidosis: A Multidisciplinary Approach. Front Immunol[Internet]. 2020[Citado 20/05/2023]; 11: 545413. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732561/
9. Lopez MC, Amadeu TP, Ribeiro-Alves M, et al. Defining prognosis in sarcoidosis. Medicine (Baltimore) [Internet]. 2020[Citado 20/05/2023]; 99(48): e23100. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33235069/
10. Baughman RP, Valeyre D, Korsten P, et al. ERS clinical practice guidelines on treatment of sarcoidosis. Eur Respir J[Internet]. 2021[Citado 20/05/2023]; 58(6): 2004079. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34140301/
11. Comité Nacional de Endocrinología. Consideraciones para una corticoterapia segura. Arch. Argent Pediatr[Internet]. 2018[Citado 20/05/2023]; 116(Supl3): S71-S76. Disponible en: https://www.sap.org.ar/docs/publicaciones/archivosarg/2018/v116n3a33s.pdf
12. Campbell A M, Martin J R, Erstad B L. Corticosteroid Tapering Regimens in Rheumatic Disease: A Systematic Review. J Clin Rheumatol[Internet]. 2020[Citado 20/05/2023]; 26(2): 41-47. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32073513/
13. Culver DA, Judson MA. New advances in the management of pulmonary sarcoidosis. BMJ[Internet]. 2019[Citado 20/05/2023]; 367: l5553. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31641045/j
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