A 26-year-old woman presents with fever, tender erythematous nodules over both shins, arthralgia, and a chest radiograph showing bilateral hilar lymphadenopathy. Angiotensin converting enzyme level is raised. What is the syndrome and its prognosis?
- A Heerfordt syndrome, poor prognosis
- B Lofgren syndrome, excellent spontaneous resolution ✓
- C Mikulicz syndrome, needs lifelong steroids
- D Darier-Roussy sarcoidosis, progressive fibrosis
Correct answer: B. Lofgren syndrome, excellent spontaneous resolution
Explanation
The triad of erythema nodosum, bilateral hilar lymphadenopathy, and ankle arthritis or fever defines Lofgren syndrome, an acute presentation of sarcoidosis with an excellent prognosis and spontaneous resolution in most patients within two years. Heerfordt syndrome features uveitis, parotitis, fever, and facial palsy, and Darier-Roussy refers to deep subcutaneous sarcoidal nodules, so neither matches this benign self-limiting picture.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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