Löfgren ‘s syndrome is a subtype of sarcoid. The triad is characteristic of this, i.e. the simultaneous occurrence of three symptoms: erythema nodosum, bihilar lymphadenopathy and arthritis.
What is Löfgren Syndrome?
According to Bittranslators, Löfgren’s syndrome is the acute form of sarcoidosis. It is named after Sven Halvar Löfgren, the first to describe it. Löfgren’s syndrome, a highly acute condition, usually begins very suddenly. The visible signs of disease include erythema nodosum and arthritis.
Bihilar lymphadenopathy leads to the diagnosis of the disease, but this can usually only be shown by an X-ray of the lungs. Young people in particular (more women than men) are affected by the disease, with a peak incidence between 20 and 30 being observed. Löfgren’s syndrome can cause numerous symptoms.
The causes of Löfgren’s syndrome are still unknown. With regard to the incidence of the disease, however, a seasonal fluctuation can be observed (peaks in spring and autumn), but this background could not be explained at the moment either. All currently known findings indicate that Löfgren’s syndrome is an overreaction of the immune system.
There may be a variety of triggers for this. These include, for example, inhalative noxae, i.e. damage and impairments caused by inhalation. Furthermore, it is often observed that Löfgren’s syndrome occurs shortly after childbirth.
The reason is considered to be a faulty conversion of one’s own immune system after pregnancy. The psyche also seems to be important, since Löfgren’s syndrome also occurs when there is a great deal of mental stress.
Symptoms, Ailments & Signs
The symptoms that Löfgren’s syndrome causes are diverse and can vary significantly between patients. The symptoms of the disease also depend on whether the course is acute or chronic.
- Acute progressive form
In the acute variant, which affects around a third of patients, the disease usually begins suddenly. Symptoms include fever (sometimes very high), night sweats, exhaustion, loss of performance, nausea and vomiting.
But also stomach problems, painful inflamed skin nodules (preferably on the legs), acute joint inflammation with pain in the joints (arthritis), swollen lymph nodes between the lungs that can only be seen on the X-ray and slight shortness of breath can occur. Coughing or weight loss are rather rare.
- Chronic form
The chronic form begins insidiously. It also lasts longer than the acute form. The patients often have no symptoms and do not feel restricted in their performance. Other sufferers, in turn, suffer from general symptoms, such as tiredness, weakness, lack of performance, outbreaks of sweating, dry, hacking cough, and a feeling of pressure in the chest.
Depending on which organs are affected by the disease, it is also possible that visual disturbances, a changed complexion, cardiac arrhythmia or other symptoms may occur. As the disease progresses, stress can also lead to symptoms such as shortness of breath and weight loss.
Diagnosis & course of disease
In most patients suffering from Löfgren’s syndrome, the typical laboratory findings cannot be detected. As a result, the disease is not diagnosed or only diagnosed late. As a rule, the course of Löfgren’s syndrome is positive. The disease resolves completely in most patients after a few weeks or months.
Acute sarcoidosis heals without treatment in the majority of cases. The strong initial symptoms usually subside significantly or have disappeared completely after four to six weeks. The other signs of the disease can persist for a longer period of time.
In general, it is possible that the patient may take a year or more to feel completely healthy and productive again. The disease rarely causes permanent damage to various organs such as the skin, lungs or heart. In the chronic course, Löfgren’s syndrome heals without consequences in about half of the patients.
The symptoms that can occur as a result of Löfgren’s syndrome are very diverse. For this reason, a direct and quick diagnosis of this disease is not possible in most cases, so that the disease cannot usually be treated at an early stage. In most cases, those affected suffer from a strong fever.
This also leads to exhaustion and a significantly reduced resilience of the patient. Furthermore, those affected by Löfgren’s syndrome also suffer from nausea or nausea. The quality of life is significantly reduced and limited by this syndrome. Not infrequently, it can also lead to pneumonia and thus to shortness of breath. In severe cases, this can also lead to a loss of consciousness, which can possibly injure the person concerned.
In the worst case, heart problems can also lead to sudden cardiac death in the patient. Löfgren’s syndrome is treated with the help of cortisone and in many cases leads to a positive course of the disease. However, early treatment is necessary to prevent consequential damage or complications.
When should you go to the doctor?
Fever, cough and rheumatic complaints indicate a serious condition that needs to be diagnosed by a doctor. If these symptoms appear, it is best to see your family doctor immediately so that a diagnosis can be made quickly. People between the ages of 20 and 40 are particularly at risk, especially young women and middle-aged men. The disease also occurs mainly in spring and autumn. People who belong to the risk groups mentioned or who suffer from an immune deficiency should go to the general practitioner with the symptoms described.
Starting treatment early improves the chances of recovery significantly. Nevertheless, regular visits to the doctor are indicated during and after the therapy. In addition to the family doctor, Löfgren’s syndrome can be treated by dermatologists, internists and rheumatologists, depending on the type and severity of the clinical picture. If the course is severe with muscle damage and neurological deficits, a physiotherapist may have to be consulted. Seriously ill patients should seek accommodation in a specialist clinic together with their family doctor at an early stage.
Treatment & Therapy
The treatment of Löfgren’s syndrome depends primarily on the symptoms and the resulting functional impairment. Therapy usually starts with cortisone-free anti-inflammatory drugs. If there is highly acute arthritis and pronounced inflammatory activity, cortisone is usually used. It is important that the cortisone dose should be sufficiently high in the initial phase.
In addition, it must not be reduced or discontinued too quickly during therapy in order to avoid a relapse with even more severe symptoms. The dose reduction depends on how the patient responds to the initial treatment and how laboratory values develop.
The acute phase in particular should be carefully monitored. Optimal treatment requires a lot of experience. If Löfgren’s syndrome takes a chronic course, further diagnostics and appropriate therapy are required.
Outlook & Forecast
Although the process of diagnosis and the path to recovery are complex and lengthy, the prognosis is still favorable. In principle, there is a chance that you will be free of symptoms even if you do not seek medical care. In most cases, those affected suffer from a variety of symptoms for several months. These lead to a severe impairment of lifestyle and thus limit the quality of life.
Nevertheless, a positive course of the disease is documented in most patients. In exceptional cases, the shortness of breath can lead to psychological problems. Fear or panic sets in, which in particularly severe cases can lead to an anxiety disorder. This circumstance must be taken into account when making an overall prognosis. The sooner it is possible to make the diagnosis, the faster it is usually possible to react.
There are various therapeutic approaches that can be used. Since the disease usually occurs sporadically, this complicates the diagnosis. Since the cause of Löfgren’s syndrome has not yet been clarified, symptomatic therapy takes place. The immune system is supported so that the overreaction is avoided in the future. The organism of the affected person is often in a phase of heavy stress when the symptoms appear. If stressors are reduced and lifestyle optimized, improvements and changes in symptoms can be identified.
Prevention of Löfgren’s syndrome is currently not possible because too little is known about the causes of the disease and how it can be influenced. In more than half of those affected, Löfgren’s syndrome goes away on its own. In other cases, it is important to stick to the recommended treatment.
This serves the purpose of preventing the progression of the disease and possible organ damage. Some patients also receive rehabilitation to restore physical and mental abilities. A stay by the sea also has a positive effect due to the healing climate. This can strengthen the immune system, which supports the healing process.
In most cases, Löfgren’s syndrome is associated with various complications and symptoms that need to be examined and treated by a doctor during follow-up care. The rehabilitation measures are aimed at restoring the usual physical condition, which depends on the degree of the illness. Most of those affected react irritably due to the weakening or suffer from depression and other mental upsets. Relaxing exercises like yoga or meditation can contribute to the recovery process. In many cases, however, the life expectancy of those affected is limited.
You can do that yourself
Löfgren’s syndrome, a special form of sarcoidosis, is usually benign. Spontaneous healing occurs in approximately 80 to 90 percent of all patients. Nevertheless, the healing process can still be accelerated through personal commitment.
In the rehabilitation phase, the patient should be treated regularly in specialist clinics that deal specifically with sarcoid and its effects. Rehabilitation clinics with a special healing climate are recommended, if possible located at high altitudes or by the sea. Consistent exercise therapy is of particular importance. Therefore, the patient in the rehabilitation period should take daily walks in the fresh air to strengthen the body’s defenses. At the same time, the movement also ensures better tolerability of the drug effect. However, since Löfgren’s syndrome manifests itself in a variety of ways, there is no uniform rehabilitation concept. The use of medication depends on the severity of the disease.
For many patients, however, it is also helpful to exchange ideas with other sufferers. There are also self-help groups for sarcoidosis patients that hold regular meetings to share experiences. Although the disease usually heals on its own, the shared experiences can provide a positive force for accelerated healing. In addition to the exchanged experiences, those affected also get the feeling that they are not alone with their complaints and problems and that it is possible to successfully overcome the disease.