Case 4-2001: acute sarcoidosis

To the Editor: the February 8 Case Record involves a patient with Löfgren's syndrome. In his discussion of the case, Dr. Bates does not sufficiently emphasize the importance of the recognition of periarticular ankle inflammation as a particular presenting sign of acute sarcoidosis. In the Nordic countries and Spain, Löfgren's syndrome is the most common form of the disease and frequently starts with periarticular ankle inflammation. In our series of 186 white patients with Löfgren's syndrome, 35 (19 percent) presented with periarticular ankle inflammation alone and 46 (25 percent) had periarticular ankle inflammation in association with erythema nodosum.