Izumo Mayu, Sekiya Kiyoshi, Sakai Toshihiko, Tojima Hirokazu
Department of Internal Medicine, Tokyo Rosai Hospital.
Nihon Kokyuki Gakkai Zasshi. 2005 Dec;43(12):761-5.
A 27-year-old man initially had low back pain and ankle arthralgia. He was admitted because fever, cough, and polyarthralgia developed and continued for three months. Chest X-ray and CT revealed bilateral hilar and mediastinal lymphadenopathy with pulmonary lesions. Furthermore, elevated serum-ACE level and noncaseating epitheloid cell granuloma obtained by TBLB confirmed the diagnosis of sarcoidosis. After hospitalization, erythema nodosum appeared and ocular involvement was demonstrated. As a result, this case fulfilled the criteria of Löfgren's syndrome (arthritis, erythema nodosum, and BHL). Löfgren's syndrome is not uncommon in European countries, but is extremely rare in Japan. So far, only six cases with Löfgren's syndrome were reported in Japan, and all were female cases. This is the first male case in Japan. Löfgren's syndrome is usually a self-limiting disease. We used steroids for this case and remission has been maintained after the beginning of the treatment for the past one year.
一名27岁男性最初出现腰痛和踝关节疼痛。因发热、咳嗽和多关节痛持续3个月而入院。胸部X线和CT显示双侧肺门及纵隔淋巴结肿大伴肺部病变。此外，血清血管紧张素转换酶（ACE）水平升高以及经支气管肺活检获得的非干酪样上皮样细胞肉芽肿确诊为结节病。住院后出现结节性红斑并证实有眼部受累。因此，该病例符合Löfgren综合征（关节炎、结节性红斑和双侧肺门淋巴结肿大）的诊断标准。Löfgren综合征在欧洲国家并不少见，但在日本极为罕见。迄今为止，日本仅报道过6例Löfgren综合征病例，且均为女性。这是日本首例男性病例。Löfgren综合征通常是一种自限性疾病。我们对该病例使用了类固醇药物，自治疗开始后的一年来病情一直保持缓解。
