A 31-year-old woman presents with subacute fever, painful tender nodules over both shins, bilateral ankle arthritis, and a chest radiograph showing symmetric bilateral hilar lymphadenopathy. Transbronchial biopsy demonstrates noncaseating epithelioid granulomas. She is normocalcemic with preserved lung function. Which statement best characterizes her condition?

• A It carries a high risk of progression to end-stage fibrosis requiring transplantation
• B It represents an acute sarcoidosis variant with an excellent prognosis and often resolves spontaneously ✓
• C It mandates immediate high-dose corticosteroids for at least two years
• D It is almost invariably complicated by uveitis and cardiac conduction block

Explanation

This is Lofgren syndrome: the triad of erythema nodosum, bilateral hilar lymphadenopathy, and ankle arthritis or periarthritis with fever, seen predominantly in young women. It is the classic acute presentation of sarcoidosis and carries the best prognosis of any phenotype, resolving spontaneously within months to a couple of years, so treatment is symptomatic with NSAIDs unless organ function is threatened. Cardiac and ocular complications belong mainly to chronic multisystem disease, not this form.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.