scholarly journals Lofgren’s syndrome: A case report and review of the literature

2021 ◽  
Vol 2 (6) ◽  
Author(s):  
Dong Bingzi ◽  
◽  
Zhao Qian ◽  
Wang Mei ◽  
Li Jinfeng ◽  
...  
Keyword(s):  
Erythema Nodosum ◽  
Symptomatic Relief ◽  
Elevated Serum ◽  
Acute Onset ◽  
Serum Angiotensin Converting Enzyme ◽  
Asian Patients ◽  
First Choice ◽  
Löfgren’S Syndrome ◽  
Classical Triad ◽  
Almost All

Lofgren’s syndrome is a variant of acute-onset sarcoidosis, characterized as Hilar Lymphadenopathy (HL), Erythema Nodosum (EN) and bilateral arthritis or arthralgia, with elevated serum Angiotensin Converting Enzyme (ACE) and calcium level. It is relatively common in Caucasians, but rarely reported in Asian countries. We reported a 72-year old Chinese female with HL, acute onset EN, multiple arthritis and arthralgia, and achieved remission with prednisolone treatment. We summarized reported cases in European and Asia countries, and investigated the characteristics of etiology, genetics, prognosis and therapeutic strategy variants due to different ethnicities. Almost all the patients showed HL, and half of them exhibited classical triad. ACE, the biomarker of Lofgren’s syndrome, elevated in more than half of the European cases, but only 30% in Asian patients. NASID is considered as the first choice of Lofgren’s syndrome, and glucocorticoid may be necessary in severe cases. One quarter of the cases from European countries need steroid therapy. However, the proportion is much higher (64.3%) to achieve symptomatic relief. Considering Lofgren’s syndrome is rare and less recognized from sarcoidosis in Asian patients, further investigation is needed to achieve clinical experience. Keywords: lofgren’s syndrome; lymphadenopathy; erythema nodosum; arthritis; sarcoidosis.

scholarly journals Acute-onset Sarcoidosis with Erythema Nodosum and Polyarthralgia (Löfgren's Syndrome) in Japan: a Case Report and a Review of the Literature

2006 ◽  
Vol 45 (9) ◽  
pp. 659-662 ◽  
Author(s):  
Hiromitsu Ohta ◽  
Ryushi Tazawa ◽  
Atsushi Nakamura ◽  
Yuichiro Kimura ◽  
Makoto Maemondo ◽  
...  
Keyword(s):  
Case Report ◽  
Erythema Nodosum ◽  
Acute Onset ◽  
Review Of The Literature ◽  
Löfgren’S Syndrome

Nonlife-Threatening Sarcoidosis

2020 ◽  
Vol 41 (05) ◽  
pp. 733-740
Author(s):  
Marina Dornfeld Cunha Castro ◽  
Carlos Alberto de Castro Pereira
Keyword(s):  
Erythema Nodosum ◽  
Acute Onset ◽  
Treatment Withdrawal ◽  
Unknown Etiology ◽  
Disease Course ◽  
Disease Evolution ◽  
Bilateral Hilar Lymphadenopathy ◽  
Inflammatory Processes ◽  
Spontaneous Involution ◽  
Löfgren’S Syndrome

AbstractSarcoidosis is a systemic granulomatous disease of unknown etiology. The outcome is quite variable and is mainly related to persistent inflammatory processes and the development of fibrosis. Many prognostic factors have been described, but the disease evolution is not yet entirely known. The nonthreatening course is characterized by spontaneous involution or stability after treatment withdrawal. Löfgren's syndrome is a subset within the spectrum of sarcoidosis phenotypes, composed of acute onset of fever, bilateral hilar lymphadenopathy, erythema nodosum and/or bilateral ankle periarticular inflammation/arthritis, specifically characterized by a self-limiting disease course. In contrast, advanced fibrotic sarcoidosis with pulmonary hypertension phenotype is correlated with a poor prognosis. Further studies are necessary to detail phenotypes to better understand the mechanisms of the disease and plan future clinical therapeutic studies.

scholarly journals Pyoderma Gangrenosum and Erythema Nodosum Revealing Takayasu’s Arteritis

2016 ◽  
Vol 8 (3) ◽  
pp. 354-357 ◽  
Author(s):  
Jonas Loetscher ◽  
Susanna Fistarol ◽  
Ulrich A. Walker
Keyword(s):  
Pyoderma Gangrenosum ◽  
Erythema Nodosum ◽  
Takayasu’S Arteritis ◽  
Skin Lesions ◽  
Takayasu's Arteritis ◽  
Young Females ◽  
Worldwide Distribution ◽  
Asian Populations ◽  
Asian Patients ◽  
Caucasian Female

We report a Caucasian female who presented with simultaneous erythema nodosum and pyoderma gangrenosum due to underlying Takayasu’s arteritis. Takayasu’s arteritis is a chronic large vessel vasculitis of unknown cause. The disease has a worldwide distribution but is most commonly seen in Asian populations. There is a strong predilection for young females. The clinical presentation is variable, but mostly derives from stenosis or occlusion of affected arteries, resulting in claudication and ischemia. Skin manifestations are observed in up to 28% of patients with Takayasu’s arteritis, with erythema nodosum reported more frequently in Caucasians. Pyoderma gangrenosum is more common in Asian patients. This report demonstrates the importance to exclude Takayasu’s arteritis in patients with such skin lesions.

Diagnostic Criteria for Influenza B-Associated Reye's Syndrome: Clinical vs. Pathologic Criteria

PEDIATRICS ◽  
1977 ◽  
Vol 60 (5) ◽  
pp. 702-708
Author(s):  
Lawrence Corey ◽  
Robert J. Rubin ◽  
Dennis Bregman ◽  
Michael B. Gregg
Keyword(s):  
Disease Control ◽  
Diagnostic Criteria ◽  
Hepatic Dysfunction ◽  
Elevated Serum ◽  
Acute Onset ◽  
Demographic Characteristics ◽  
Influenza B ◽  
Elevated Blood ◽  
Blood Ammonia ◽  
Reye's Syndrome

Between December 15, 1973, and June 30, 1974, a total of 379 cases of Reye's syndrome was reported to the Center for Disease Control. One hundred forty-seven (40%) were confirmed by either autopsy or biopsy, while 232 were diagnosed by clinical and laboratory parameters. Comparisons of the epidemiologic and demographic characteristics, the hospital course, the outcome, and the laboratory abnormalities of the clinically diagnosed and the pathologically confirmed cases revealed no significant differences. In the epidemiologic setting of influenza B outbreaks, children who have the acute onset of noninflammatory encephalopathy associated with elevated serum transaminase levels, hypoprothrombinemia, and elevated blood ammonia levels should be considered to have Reye's syndrome. Further evaluation of diagnostic criteria is needed, however, for sporadically occurring, nonepidemic cases of noninflammatory encephalopathy associated with hepatic dysfunction.

TOOTH-RASHES AS DESCRIBED BY MICHAEL UNDERWOOD (1737-1820), THE FOUNDER OF MODERN PEDIATRICS

PEDIATRICS ◽  
1969 ◽  
Vol 43 (3) ◽  
pp. 459-459
Author(s):  
T. E. C.
Keyword(s):  
Scarlet Fever ◽  
Erythema Nodosum ◽  
Whole Body ◽  
Deciduous Teeth ◽  
History Of ◽  
History Of Pediatrics ◽  
Benign Nature ◽  
Almost All ◽  
As If

I know of no contemporary pediatrician who believes that the cutting of deciduous teeth causes skin rashes. But, almost all the great figures in the history of pediatrics believed firmly that teething was associated with a riety of rashes. Michael Underwood, who more than anyone else laid the foundation of modern pediatrics, wrote about tooth-rashes as follows: A very common rash, appears chiefly in teething children, which yery much resembles the measles, and has been sometimes mistaken for it. It is preceded by sickness at the stomach, but is attended by very little fever; though the rash continues very florid for three days, like the measles, but does not dry off in the manner of that disease. . . . While the double or eye-teeth are cutting, I have noticed a rash Which at its first appearance is very similar to the above, and has likewise been mistaken for the measles. It, however, soon spreads into larger spots and patches of bright red, and afterwards of a darker hue, resembling the ill-looking petechiae which appear in bad fevers, but is, nevertheless, of a benign nature. It is, indeed, attended with some fever, arising possibly from the irritation occasioned by teething, and has been followed by small and hard round tumours on the legs, which softening in two or three days, always appear as if they would suppurate, though I believe they never do . . . [? erythema nodosum, T. E. C., Jr.] I have seen a third kind of rash, in appearance resembling the measles, and, like it, covering the whole body, but with larger intermediate patches, like the eruption in the scarlet fever. . . .

scholarly journals Acute and Chronic Sarcoid Arthropathies: Characteristics and Treatments From a Retrospective Nationwide French Study

2020 ◽  
Vol 7 ◽  
Author(s):  
Carlotta Cacciatore ◽  
Pierre Belnou ◽  
Sara Thietart ◽  
Carole Desthieux ◽  
Mathilde Versini ◽  
...  
Keyword(s):  
Erythema Nodosum ◽  
Skin Lesions ◽  
Tnf Inhibitors ◽  
Joint Involvement ◽  
Clinical Phenotypes ◽  
Treatment Regimens ◽  
French Study ◽  
Histological Criteria ◽  
Multicenter Analysis ◽  
Löfgren’S Syndrome

Introduction: We aimed to analyze patients with acute and chronic joint involvements in sarcoidosis.Methods: This is a retrospective multicenter analysis of patients with proven sarcoidosis, as defined by clinical, radiological, and histological criteria, with at least one clinical and/or ultrasonographic synovitis.Results: Thirty-nine patients with sarcoid arthropathy were included, and among them 19 had acute sarcoidosis (Lofgren's syndrome). Joint involvement and DAS44-CRP were not significantly different in acute and chronic sarcoid arthropathies. Acute forms were more frequent than chronic sarcoid arthropathy in Caucasians, without any difference of sex or age between these 2 forms. Joint involvement was frequently more symmetrical in acute than chronic forms (100 vs. 70%; p < 0.05), with a more frequent involvement in wrists and ankles in acute forms, whereas the tender and swollen joint counts and the DAS44-CRP were similar between the 2 groups. Skin lesions were significantly more frequent in patients with acute forms [17 (89%) vs. 5 (25%); p < 0.05] and were erythema nodosum in all patients with Löfgren's syndrome and sarcoid skin lesions in those with chronic sarcoidosis. Among 20 patients with chronic sarcoidosis, treatment was used in 17 (85%) cases, and consisted in NSAIDs alone (n = 5; 25%), steroids alone (n = 5; 25%), hydroxychloroquine (n = 2; 20%), methotrexate (n = 3; 15%), and TNF inhibitors (n = 2; 10%). A complete/partial joint response was noted in 14 (70%) cases with a DAS44-CRP reduction of 2.07 [1.85–2.44] (from 3.13 [2.76–3.42] to 1.06 [0.9–1.17]; p < 0.05).Conclusion: Sarcoid arthropathies have different clinical phenotypes in acute and chronic forms and various treatment regimens such as hydroxychloroquine and methotrexate could be used in chronic forms.

The etiology of erythema nodosum

1926 ◽  
Vol 22 (11) ◽  
pp. 1298-1298
Author(s):  
E. Lepsky
Keyword(s):  
Erythema Nodosum ◽  
Protective Activity ◽  
Bronchial Glands ◽  
Almost All

The 81 children observed by the author, aged from 12 months to 13 years, suffering from erythema nodosa, all reacted very strongly to tuberculin. Almost all had enlarged bronchial glands or the temporary darkening at the root of the lungs described by Ernberg; some had simultaneous frictions, lichen scrophulosorum or serous pleurisy. The author considers the nodular erythema a manifestation of the protective activity of the skin, in which the tbc bacilli circulating in the blood or their products are neutralized.

Variability in Case Mix and Peritoneal Dialysis Selection in Fifty-Nine French Districts

2008 ◽  
Vol 28 (5) ◽  
pp. 509-517 ◽  
Author(s):  
Cécile Couchoud ◽  
Emilie Savoye ◽  
Luc Frimat ◽  
Jean-Philippe Ryckelynck ◽  
Ylana Chalem ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Peritoneal Dialysis ◽  
Behavioral Disorders ◽  
Hierarchical Classification ◽  
Ratio Test ◽  
First Choice ◽  
Stage Renal Disease ◽  
Almost All ◽  
End Stage

In France, the use of peritoneal dialysis (PD) as the first-choice treatment varies greatly between districts, as it is already known to do between countries. Baseline clinical factors associated with choice of first modality were analyzed in 10815 new end-stage renal disease patients in 59 districts. To describe practices at the district level, we used an agglomerative hierarchical classification, with proximity defined by a likelihood-ratio test that compared multivariate logistic regressions of the following factors: age, gender, diabetes, congestive heart failure, severe behavioral disorders, mobility, and employment. To propose a typology, each cluster of districts was described by a multivariate logistic regression. While populations starting PD in France, as elsewhere, are more likely to be young or employed, they are also more likely to be elderly or have congestive heart failure or severe behavioral disorders. Overall, 14% of patients start with PD, but this rate varies significantly across districts, from 0% to 45%. A specific combination of factors was associated with the first-choice modality in each group of districts. This study highlights the lack of consensual medical criteria for this choice and the likelihood that nonmedical factors may explain the observed differences. The high variability suggests that PD can be used in almost all clinical conditions. Accordingly, patient preference should play a more important role in the decision-making process.

Septic epiphysitis and sequestrum formation in the glenoid of the scapula in a five-month-old foal diagnosed by computed tomography

2019 ◽  
Vol 7 (3) ◽  
pp. e000837
Author(s):  
Peter E Clements ◽  
Becky Jones ◽  
Richard Coomer
Keyword(s):  
Poor Prognosis ◽  
Serum Amyloid A ◽  
Proximal Humerus ◽  
Treatment Options ◽  
Elevated Serum ◽  
Acute Onset ◽  
Subchondral Bone Plate ◽  
Large Defect ◽  
Amyloid A ◽  
Bony Fragment

A five-month-old Connemara foal presented for acute-onset, severe left forelimb lameness with fever, neutrophilia and an elevated serum amyloid A concentration. Radiographs were suspicious of septic physitis of the proximal humerus. CT identified a large defect involving the central portion of the subchondral bone plate of the glenoid and a sequestered bony fragment within the defect, which were not seen radiographically. CT findings were consistent with septic epiphysitis and sequestrum formation, which had significant implications on available treatment options. The foal was given a poor prognosis for returning to soundness so was subject to humane euthanasia.

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