Clinical symptoms of joint damage in Lö fgren's syndrome

Objective: to investigate joint damage and laboratory and instrumental features in Löfgren's syndrome (LS) in patients referred to the Rheumatology Center.
Patients and methods. The five-year investigation enrolled 142 patients of both sexes (31 men and 111 women; mean age, 39.3±11.1 years) with erythema nodosum (EN) accompanied by polyarthralgias or arthritis. All the patients underwent comprehensive clinical, laboratory and instrumental examinations, including joint ultrasound and chest computed tomography.
Results and discussion. Disseminated EN that was correlated with the level of CRP was detected in 96% of cases (p=0.006; r=0.38). The signs of joint damage with predominantly periarticular changes in the ankle joints were observed in 124 (87%) patients. There was a relationship of the duration of the articular syndrome to that of inflammatory changes in subcutaneous tissue and to the number of nodules (p=0.02; r=0.45). The level of CRP had a significant direct correlation with the number of nodules (p=0.008; r=0.29) and the severity of the articular syndrome (p=0.003; r=0.29). Elevated levels of angiotensin-converting enzyme were found in 97 (78%) patients. Joint damage was significantly more frequently combined with X-ray Stage I sarcoidosis (Sr) (p=0.03). The Stage II Sr showed a male preponderance (p=0.04) and a 4.8-fold increase in the merging of subcutaneous nodes into conglomerates (p=0.002).
Conclusion. Joint damage may be one of the first signs of LS, which requires that physicians of various specialties should coordinate their actions to timely diagnose, assess activity, and choose an adequate therapeutic approach.

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