Clinical StudiesLöfgren’s syndrome revisited: a study of 186 patients
Section snippets
Definitions and diagnostic criteria
The diagnosis of sarcoidosis was made according to the classical criteria: a compatible clinical and radiologic picture; histologic demonstration of noncaseating granulomas in one or more tissues with negative stains and cultures for mycobacteria and fungi, or a positive Kveim test; and exclusion of other granulomatous diseases. Löfgren’s syndrome was defined as the association of erythema nodosum, periarticular ankle inflammation, or both with unilateral or bilateral hilar or right
Results
The diagnosis of Löfgren’s syndrome was made in 186 patients. All were white. The mean age was 37 ± 11 years (range, 14 to 66 years) and 157 (85%) were women. In 91 patients (49%), symptoms were first noticed between April and June. This seasonal distribution was significantly greater than for the other 3-month periods (P <0.0001). In 173 patients (93%) erythema nodosum, periarticular ankle inflammation, or both, sometimes accompanied by arthralgia and low-grade fever, was the initial
Discussion
This study supports the epidemiologic data that suggest that there are differences in the presentation of sarcoidosis according to the involved population (12). All of our patients were white, with a great predominance of young women. The seasonal clustering during the spring months, which has been reported previously, suggests that an environmental factor may be important in the etiology of the disease 16, 23, 24. Interestingly, many patients initially presented with periarticular ankle
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