“What’s that syndrome with erythema nodosum and sarcoidosis?”

Lofgren syndrome! Below is a quick 101 cheat sheet on Lofgren syndrome, check it out!

  • Lofgren syndrome is a form of acute sarcoidosis (not to be confused with Loffler’s syndrome)
  • Initially described in 1953 by Sven Halvar Lofgren, a Swedish clinician
  • More common in Scandinavian, Irish and African populations
  • The syndrome is comprised of the combination of
  • Erythema Nodosum
  • Hilar adenopathy
  • Migratory polyarthralgia
  • Fever
  • In men, more common to have bilateral ankle arthritis instead of EN
  • The combination of all features of Lofgren syndrome has a 95% specificity for sarcoidosis, allowing for clinical diagnosis without pathology
  • However, consider the ddx for EN and hilar adenopathy: primary TB, sarcoid, coccidiodomycosis, histo, blasto, yersiniosis and chlamydia
  • The syndrome is associated with a good prognosis
  • Some patients have spontaneous remission and others require only NSAIDs to control their symptoms
  • In one retrospective study of 80 patients, 67% were treated with NSAIDs and 41% with steroids and only 17% had a recurrence