A 30-year-old Scandinavian female presents with 2 weeks history of bilateral ankle pain. She also reports fever, easy fatigability, and loss of appetite. On examination, she has bilateral tender cutaneous nodules over the anterior surface of the legs. Her chest-X ray reveals bilateral hilar lymphadenopathy. Laboratory tests show elevated ESR, mild elevation of rheumatoid factor and positive antinuclear antibodies. Examination of other systems is unremarkable. Her vitals are stable except a temperature of 99.9F. What is the most likely diagnosis?
A. Lofgren™s syndrome.
B. Heerfordt-Waldenstrom syndrome.
C. Chronic sarcoidosis.
D. Tuberculosis.
E. Hodgkin™s lymphoma.
F. Rheumatoid arthritis.
G. Systemic lupus erythematosus.
A. Lofgren's syndrome ( Erythema Nodosum, Periarthritis , Bilateral Hilar Adenopathy.)
thought it is sarcoidosis...but have not read anyhting on lofgrens' syndrome
I donot first 2 syndromes
The Lofgren Syndrome and Heerfordt- Walderstorm syndrome are two distinct sarcoid syndromes.
Lofgren syndrome:
-Erythema Nodosum (esp. lower extremities)
-Arthritis (periarthritis of the ankles)
-Bilateral Hilar adenopathy
Heerfordt- Wladerstrom syndrome:
-Fever
-parotid enlargement
-Uveitis
-Facial palsy...
I just had similar question on smashstep1.com question bank. The explanation they gave is as follows:
Lofgren™s syndrome is an acute, self-limiting form of sarcoidosis seen in women of Scandinavian or Irish descent and is characterized by sarcoidosis with the presence of erythema nodosum and arthritis. Sarcoidosis is a non-caseating granulomatous disease that affects multiple organ systems, with the lungs most commonly involved. The condition is most common among African American females. Pulmonary symptoms include shortness of breath and a persistent cough. The classic radiographic finding associated with sarcoidosis is bilateral hilar lymphadenopathy. A lung biopsy shows non-caseating granulomas. Elevated serum angiotensin-converting enzyme levels are a marker for sarcoidosis. The condition can result in restrictive lung disease. Heerfordt-Waldenstrom syndrome is an acute form of sarcoidosis characterized by facial nerve palsy, anterior uveitis, fevers, and parotid gland enlargement.
meddoc
y it cant b ra
it haqs anti nuclear
n
rheumatoid factor?
you have to look at the whole picture:
Lofgren's is subset of sarcoidosis.
Lofgren's = sarcoidosis + erythema nodosum + arthritis