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Joint Bone Spine
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le mardi 29 octobre 2019
Doi : 10.1016/j.jbspin.2019.10.001
accepted : 1 October 2019
Sarcoidosis presenting with and without Löfgren's syndrome: Clinical, radiological and behavioral differences observed in a group of 691patients
 

Manuel Rubio-Rivas a, , Jonathan Franco b, Xavier Corbella a, c, d
a Autoimmune Diseases Unit, Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, Barcelona, Spain 
b Department of Internal Medicine, Dexeus University Hospital, Barcelona, Spain 
c Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain 
d Group of Evaluation of Health Determinants and Health Policies, Hestia Chair in Integrated Health and Social Care, Barcelona, Spain 

Corresponding author at: Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, 08907, Spain.Bellvitge University Hospital, Hospitalet de LlobregatBarcelona08907Spain
Highlights

Largest Löfgren's cohort reported to date.
They are mostly younger, females and frequently accompanied by fever and articular involvement.
Older age, stage II at diagnosis and the need of treatment are related to chronic trend.
Whether Löfgren's syndrome represents a subset or a separate entity in sarcoidosis is yet to be clarified.

The full text of this article is available in PDF format.
Abstract
Objectives

Just a few series of Löfgren's syndrome have been reported. Our aim was to describe the epidemiology and clinical profile of sarcoidosis patients presenting with Löfgren's syndrome vs. non-Löfgren's syndrome.

Methods

Retrospective cohort study of 691consecutive patients with sarcoidosis diagnosed at the Bellvitge University Hospital in Barcelona, Spain, between 1976 and 2018.

Results

Three hundred and nine patients (44.7%) were diagnosed with Löfgren's syndrome and 382with non-Löfgren's syndrome (55.3%). The mean age at diagnosis was 39.8years-old (SD 11.7) vs. 46.6 (SD 14.5) (P <0.001). 249 patients (80.6%) vs. 218 (57.1%) were female (P <0.001), and mostly Caucasians (304, 98.4% vs. 351, 91.9%, P =0.002). Out of the total 309, Löfgren's syndrome patients developed more frequently fever and articular involvement, and 45 (14.6%) presented with isolated periarticular ankle inflammation. When compared, radiological stages at diagnosis were more advanced in non-Löfgren's syndrome patients: stage 0 (2.9% vs. 14.7%), stage I (82.5% vs. 41.4%), stage II (14.6% vs. 29.3%), and stage III/IV (0 vs. 14.7%) (P <0.001). Chronic trend>2years was more prevalent in non-Löfgren's syndrome (66, 22.6% vs. 233, 67.4%; P <0.001), as well as the proportion of patients in whom treatment was needed (58, 18.8% vs. 224, 58.6%; P <0.001). Risk factors related to chronic trend>2 years were older age, stage II at diagnosis and the need of treatment.

Conclusions

Löfgren's syndrome is a well-differentiated form of sarcoidosis with persuasive different epidemiological, clinical, radiological and prognostic features.

The full text of this article is available in PDF format.

Keywords : Sarcoidosis, Löfgren's syndrome, Erythema nodosum




© 2019  Published by Elsevier Masson SAS.