[Does steroid therapy have an effect on the course of Löfgrenn syndrome? Catamnestic studies on 25 patients with Löfgren syndrome at the Zürich county hospital].

To investigate whether steroids influence the course and prognosis of acute sarcoidosis (Löfgren syndrome) 35 patients who developed this disease during the period 1960-1970 were examined and retrospectively divided into two groups, one of which had received steroids and the other not. At the onset of the disease all the patients had had typical symptoms of acute sarcoidosis: bilateral hilar lymphadenopathy, erythema nodosum, arthralgia, fever and elevated sedimentation rate. Biopsy of hilar lymphnodes had revealed non-caseating granulomas in all cases, whereas such granulomas were present in only 7 of 15 liver biopsies. The Kveim reaction was positive in 89% and the tuberculin skin test was negative in 51%. The duration of the disease was 6-7 weeks in both groups, i.e. steroid treated and non-steroid treated. The radiological chest abnormality had usually disappeared within one year. All chest X-rays had completely normalized after two years. Neither the course nor the prognosis differed in the two groups. However, patients receiving steroids had had more side effects. Acute sarcoidosis should not be treated with steroids; symptomatic therapy with other, less toxic antiinflammatory drugs suffices. The outcome is good. None of the patients has progressed to chronic sarcoidosis.