Introduction: Lofgren Syndrome (LS), a phenotype of Sarcoidosis is an acute inflammatory disease with pulmonary and extrapulmonary presentations. It is rarely seen in West Africans.
Case summary: The index patient presented with fever, pain and swelling of the wrist and ankle joints bilaterally, subcutaneous swellings (erythema nodosum) over the shin and extensor surfaces of the forearms and radiographic evidence of bilateral hilar adenopathy. Laboratory results showed elevated serum calcium, Angiotensin-converting enzyme (ACE), Aspartate transaminase (AST), Alanine transaminase (ALT), Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).
Treatment: The patient was placed on a non-steroidal anti-inflammatory drug (oral diclofenac) and oral corticosteroid (methylprednisolone) with significant pain relief within the first 1week of commencement of medications. Oral diclofenac was discontinued after 1 week and oral methylprednisolone was tailed down after 3 weeks.
Conclusion: Though rare amongst Sub-Saharan Africans, documented cases of Lofgren syndrome are increasing in number. The clinician practising in sub-Saharan Africa should be open-minded and broaden his differential to include Lofgren syndrome especially typical features are present.
Key words: Erythema nodosum, Lofgren's syndrome, Lupus pernio, Sarcoidosis
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