Systemic diseases have always been a mystery to the medical world. One of them is sarcoidosis, which has no substantiated etiology, but manifests itself in the form of inflammation of the connective tissue in various organs and tissues with the formation of granulomas. Löfgren's syndrome is a special course of sarcoidosis affecting the skin, intrasternal lymph nodes, and joints.
Reason for development
The pathogenesis is based on the development of an autoimmune reaction. The immune system fails, and white blood cells begin to attack he althy cells in the lungs, joints, and skin.
Löfgren's syndrome most often develops in young women (20-35 years old). Children usually don't get sick. Löfgren's syndrome begins acutely, and then gradually the clinical manifestations may resolve themselves. Often there is a favorable course of the disease.
In addition to the viral and bacterial theory of the development of sarcoidosis, there is also an opinion that the disease develops in people who have long-term contact with volatile chemicals in factories. Do not lose sight of the hereditary factor. That is why sarcoidosis is a polyetiological autoimmune disease.disease.
Clinical manifestations
Löfgren's syndrome in sarcoidosis manifests itself polysymptomatically. Clinical manifestations begin acutely. A person develops erythema nodosum on the body, it tends to spread to the limbs, back, abdomen, neck. The nodes are oval in shape, their diameter can reach up to 6 centimeters. It is worth noting that necrosis does not occur at the site of erythema formation.
The main manifestation is the defeat of the bronchial and tracheal lymph nodes. This is a great danger to the patient:
- cough appears;
- occasionally increased body temperature;
- feeling worse;
- night sweats occur;
- deteriorating quality of sleep;
- weight loss occurs;
- a person is anxious.
Later Löfgren's syndrome is characterized by joint damage. They become swollen, painful, and mobility worsens. Objectively, it is possible to notice an increase in the lymph nodes of the neck, as well as in the armpits.
How to diagnose?
Löfgren's syndrome is established on the basis of laboratory diagnostics and examination of the patient by a general practitioner. Erythema nodosum is of great importance in the diagnosis of this form of sarcoidosis. However, the doctor needs to differentiate the disease from tuberculosis or dermatovenereological diseases.
Laboratory blood test will show:
- increased ESR;
- leukocytosis;
- gamma appearanceglobulins.
On the x-ray, you can see a characteristic enlargement of the lymph nodes, as well as fibrous deposits. This helps to make sure in case of lung damage.
Mild form requires bronchoscopy with targeted biopsy. When examining the lung tissue, it is possible to see the characteristic histological structure of sarcoidosis: elements of an epithelioid granuloma are found.
Prognosis and complications of the disease
Löfgren's syndrome occurs individually. How long it lasts and what are the forecasts, it is possible to answer only according to certain criteria. It is known that the older the person, the worse the prognosis. If you do not see a doctor in time, the syndrome is delayed, and complications are added to it:
- bronchial obstruction;
- respiratory failure;
- development of "cor pulmonale";
- emphysema;
- attachment of bacterial flora.
Respiratory failure develops after broncho-obstruction. The patient's condition gradually deteriorates as the lungs begin to be replaced by connective tissue, the process may stop spontaneously after 1-2 years.
Gradually, the heart begins to increase due to lack of oxygen in the blood. Seeking medical attention, however, should not be ignored, as Löfgren's syndrome is now treatable.
Treatment
Unfortunately, doctors cannot completely cure sarcoidosis,since its etiology is not completely known. But doctors prescribe a special therapy that can stop the development of the process, control Lofgren's syndrome. Treatment begins with the appointment of steroidal anti-inflammatory drugs to reduce immunity. Vitamin complexes, antioxidants, immunosuppressants are also prescribed.
The course of treatment lasts an average of 8 months. It all depends on the individual characteristics of the immune system. Dispensary observation of patients by a pulmonologist is mandatory, ideally it lasts 5 years.
What prevention?
To prevent the development of sarcoidosis, first of all, you should monitor your lifestyle. Nutrition should be balanced, contain fats, proteins, carbohydrates in the optimal ratio.
People at risk for sarcoidosis should stop smoking, exposure to harsh chemicals.
