A 35-year-old woman presents with bilateral hilar lymphadenopathy on chest X-ray, erythema nodosum over both shins, arthralgia, and fever. What is the most likely diagnosis?
- A Systemic lupus erythematosus
- B Lofgren syndrome ✓
- C Whipple disease
- D Reiter syndrome
Correct answer: B. Lofgren syndrome
Explanation
Lofgren syndrome is the classic triad (or tetrad) of sarcoidosis: bilateral hilar lymphadenopathy, erythema nodosum, arthralgia, and fever. It carries an excellent prognosis with spontaneous resolution. Reiter syndrome involves the conjunctivitis-urethritis-arthritis triad. Whipple disease causes malabsorption, and SLE would not produce hilar lymphadenopathy with this presentation.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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