A 40-year-old woman presents with bilateral hilar lymphadenopathy, erythema nodosum, polyarthritis, and fever for 3 weeks. CXR confirms bilateral hilar lymphadenopathy with no parenchymal infiltrates. HRCT, bronchoscopy with BAL, and transbronchial biopsy are being arranged. What is the specific clinical syndrome described here?
- A Heerfordt's syndrome
- B Mikulicz syndrome
- C Siltzbach syndrome
- D Löfgren's syndrome ✓
Explanation
Löfgren's syndrome is an acute presentation of sarcoidosis characterized by the triad of bilateral hilar lymphadenopathy, erythema nodosum, and polyarthritis (often ankle periarthritis), frequently with fever. It carries an excellent prognosis with spontaneous resolution in over 85% of cases and does not always require biopsy for diagnosis. Heerfordt's syndrome features uveoparotid fever (uveitis, parotid swelling, facial nerve palsy). Mikulicz syndrome refers to bilateral parotid and lacrimal gland enlargement. NSAIDs are sufficient for management in most Löfgren's cases.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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