Sarcoidosis is a chronic multisystemic, inflammatory, granulomatous disorder of unknown etiology; It is commonly associated with erythema nodosum, anterior uveitis.
Lofgren syndrome is an acute presentation of systemic sarcoidosis, characterized by the triad of fever, erythema nodosum, and bilateral hilar adenopathy.
Diagnosis:-
1. Increased serum calcium and 1,25 dihydroxyvitamin D3 (i.e. 1 alpha hydroxylase present on granulomas leads to increased synthesis of 1,25 dihydroxy vitamin D3).
2. Elevated ACE levels.
3. Chest x ray/CT scan shows bilateral hilar and paratracheal lymphadenopathy (i.e. pawnbroker’s sign).
4. HRCT scan shows galaxy sign.
5. Histology shows non-caseating granulomas with epithelioid cells.
6. Bronchoalveolar lavage shows elevated CD4/CD8 ratio (i.e. CD4/CD8 >3.5).
Stages:-
1. I:- hilar lymphadenopathy
2. II:- hilar lymphadenopathy + infiltrates
3. III:- infiltrates
4. IV:- fibrosis (i.e. eggshell calcification)
Treatment:- Steroids.
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