Oshima Miki, Maeda Hiroyuki, Furonaka Osamu, Doi Masao, Nishizaka Takashi, Kuwabara Masao
Department of Respiratory Medicine and Rheumatology, Hiroshima Prefectural Hospital, 1-5-54 Ujina-kanda, Minami-ku, Hiroshima 734-8530.
Intern Med. 2003 Jun;42(6):534-7. doi: 10.2169/internalmedicine.42.534.
A 52-year-old woman was admitted because of high-grade remittent fever, erythema nodosum, and arthritis which had been lasting two months. Antibiotics did not improve her condition. A chest CT scan examination revealed bilateral hilar and mediastinal adenopathy and multiple nodular opacities in the bilateral lungs. The wedge biopsy of the right lower lobe using video-assisted thoracoscopy presented the histological findings of sarcoidosis. Finally, this case fulfilled the criteria of Löfgren's syndrome. Due to the uncovered cardiac involvement, the systemic glucocorticoid therapy had to be initiated. This case suggests that atypical forms of sarcoidosis should be kept in mind as well, when facing cases with unknown fever.
一名52岁女性因高热弛张热、结节性红斑和关节炎持续两个月入院。抗生素治疗未能改善她的病情。胸部CT扫描检查显示双侧肺门和纵隔淋巴结肿大以及双肺多发结节状阴影。使用电视辅助胸腔镜对右下叶进行楔形活检呈现出结节病的组织学表现。最终，该病例符合 Löfgren 综合征的标准。由于未发现心脏受累情况，不得不开始全身性糖皮质激素治疗。该病例表明，在面对不明发热病例时，也应考虑到结节病的非典型形式。
