Acute arthritis occurs in up to 40% patients with sarcoidosis and can be the presenting manifestation, usually as a part of Lofgren syndrome
(a triad of acute arthritis, bilateral hilar adenopathy, and erythema nodosum) (1, 2, 5).
Stankovic et al., "Lofgren syndrome
and peritoneal involvement by sarcoidosis: Case report," CHEST, vol.
Her EN and joint pain were concerning for an autoimmune process, particularly acute sarcoidosis (Lofgren syndrome); therefore antibiotics were discontinued and she was started on ibuprofen 800 mg every 8 hours.
At this point, acute sarcoidosis (Lofgren syndrome) was ruled out.
The majority of cases (5/6) were pulmonary with mainly hilar and/or mediastinal adenopathies; one male patient had Lofgren syndrome.
In fact, other authors concluded that there was no clinical difference between familial sarcoidosis and usual forms of the disease (13), only Lofgren syndrome stood out (14).In our case, the relationship is a brother to brother matter.
In studies investigating the association between non-HLA genes and sarcoidosis (Table 2), TNF-308A allele gene polymorphism was detected to be correlated with Lofgren syndrome