title: [A case of sarcoidosis with rheumatic features (Löfgren's syndrome)].
abstract: Rheumatoid arthritis was diagnosed in a 30-year-old woman with erythema nodosum and arthritic symptoms since 1994, and she was treated with anti-rheumatic agents. Mediastinal and bilateral hilar lymphadenopathy and abnormal pulmonary shadows were detected in 1996, and she was admitted to our hospital in 1997. We also recognized the elevation of ACE and lysozyme, and found granulomas in a transbronchial lung biopsy and an arthrosis synovia biopsy. From these findings, sarcoidosis was diagnosed. Sarcoidosis demonstrating erythema nodosum, arthritis, and bilateral hilar lymphadenopathy is called Löfgren's syndrome. In Caucasians, Löfgren's syndrome is frequently encountered, but it is rare in Japanese. Our case had coexisting arthrosis symptoms, and satisfied the diagnosis criteria of rheumatic arthritis. Therefore, the differential diagnosis was important. We emphasize that it is necessary to consider Löfgren's syndrome when diagnosing patients with rheumatic features, even in Japan.
authors.affiliation: Department of Internal Medicine and Molecular Science, Nagoya City University Graduate School of Medical Science, Nagoya, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Niimi
authors.forename: Shigeki
authors.initials: S
authors.lastname: Sato
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sugiura
authors.forename: Kenji
authors.initials: K
authors.lastname: Akita
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Maeda
authors.forename: Shigemitsu
authors.initials: S
authors.lastname: Ninomiya
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Achiwa
authors.forename: Sonoko
authors.initials: S
authors.lastname: Masui
authors.forename: Yuji
authors.initials: Y
authors.lastname: Bessho
authors.forename: Ken
authors.initials: K
authors.lastname: Maeno
authors.forename: Taio
authors.initials: T
authors.lastname: Naniwa
authors.forename: Masanori
authors.initials: M
authors.lastname: Kotsuka
authors.forename: Munehiko
authors.initials: M
authors.lastname: Morishita
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Ueda
mesh_terms: D000328:Adult; D001168:Arthritis / Q000175:diagnosis / Q000473:pathology; D001172:Arthritis, Rheumatoid; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D004893:Erythema Nodosum / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology; D008206:Lymphatic Diseases / Q000175:diagnosis* / Q000473:pathology; D009113:Muramidase / Q000097:blood; D007703:Peptidyl-Dipeptidase A / Q000097:blood; D012507:Sarcoidosis / Q000175:diagnosis* / Q000473:pathology; D013577:Syndrome; D013583:Synovial Membrane / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D009113:Muramidase; D007703:Peptidyl-Dipeptidase A