Löfgren syndrome
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Synopsis

Löfgren syndrome is a constellation of symptoms that is nearly always suggestive of acute sarcoidosis. The primary symptoms are erythema nodosum and hilar lymphadenopathy. Arthritis, uveitis, and fever also frequently occur. Primary tuberculosis can rarely present with hilar lymphadenopathy and erythema nodosum. The simultaneous presence of all the typical features of Löfgren syndrome, however, is highly specific for sarcoidosis.
Löfgren syndrome predominantly occurs in female patients of Northern European descent. Unlike other manifestations of sarcoidosis, Löfgren syndrome usually resolves within 2 years and rarely relapses. NSAIDs are the typical treatment, with immunosuppression sometimes required.
Löfgren syndrome predominantly occurs in female patients of Northern European descent. Unlike other manifestations of sarcoidosis, Löfgren syndrome usually resolves within 2 years and rarely relapses. NSAIDs are the typical treatment, with immunosuppression sometimes required.
Codes
ICD10CM:
D86.86 – Sarcoid arthropathy
SNOMEDCT:
238676008 – Lofgrens syndrome
D86.86 – Sarcoid arthropathy
SNOMEDCT:
238676008 – Lofgrens syndrome
Differential Diagnosis & Pitfalls
Differential diagnosis depends on presenting symptoms.
See erythema nodosum for a differential of skin findings, and also consider:
See erythema nodosum for a differential of skin findings, and also consider:
- Lupus panniculitis
- Ecchymoses
- Sweet syndrome
- Fat necrosis
- Drug-induced erythema nodosum (eg, oral contraceptives)
- Inflammatory bowel disease (eg, Crohn disease, ulcerative colitis)
- Fungal infections (eg, histoplasmosis)
- Bacterial infections (eg, Streptococcus, Yersinia)
- Cat-scratch disease
- Malignancy (particularly lymphoma, lung, metastasis)
- Fungal infection (eg, histoplasmosis, coccidioidomycosis)
- Histiocytic diseases
- Pneumonia
- Human immunodeficiency virus infection
- Tuberculosis
- Systemic lupus erythematosus
- Pneumoconiosis (eg, silicosis, asbestosis)
- Rheumatoid arthritis
- Reactive arthritis
- Still disease
- Systemic lupus erythematosus
- Psoriatic arthritis
- Ankylosing spondylitis
- Other connective tissue diseases
- Septic arthritis
- Osteoarthritis
- Trauma
- Avascular necrosis
- Tendonitis
- Bursitis
- Meniscal disease
- HLA-B27 autoimmune diseases (eg, inflammatory bowel disease [ulcerative colitis, Crohn disease], ankylosing spondylitis, psoriasis)
- Behçet syndrome
- Viral infection (eg, herpes viruses [herpes simplex, herpes zoster]),
- Bacterial infections (eg, syphilis, mycobacteria)
- Toxoplasmosis
- Fungal infections (eg, cryptococcosis)
- Acute angle-closure glaucoma
- Conjunctivitis (eg, viral, bacterial, allergic)
- Scleritis (eg, diffuse)
- Episcleritis (eg, diffuse)
- Ocular foreign body
- Corneal abrasion
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Last Updated:05/26/2016