Case 4-2025: A 41-Year-Old Man with Syncope, Ankle Swelling, and Abnormal Chest Imaging

A 41-year-old man with a history of coronary artery disease presented with syncope, bilateral ankle swelling, fever, and inflammatory arthritis. Imaging revealed bilateral hilar lymphadenopathy, pulmonary nodules, and erythema nodosum, consistent with Löfgren’s syndrome, an acute manifestation of sarcoidosis. Cardiac evaluation ruled out significant myocardial involvement. The patient responded well to a tapering course of glucocorticoids, with resolution of symptoms and radiographic improvement. This case highlights the classic triad of Löfgren’s syndrome and underscores the importance of distinguishing sarcoidosis from infectious, malignant, and other autoimmune etiologies in patients with systemic inflammatory symptoms.

A 41-year-old man with a history of coronary artery disease presented with syncope, bilateral ankle swelling, fever, and inflammatory arthritis. Imaging revealed bilateral hilar lymphadenopathy, pulmonary nodules, and erythema nodosum, consistent with Löfgren’s syndrome, an acute manifestation of sarcoidosis. Cardiac evaluation ruled out significant myocardial involvement. The patient responded well to a tapering course of glucocorticoids, with resolution of symptoms and radiographic improvement. This case highlights the classic triad of Löfgren’s syndrome and underscores the importance of distinguishing sarcoidosis from infectious, malignant, and other autoimmune etiologies in patients with systemic inflammatory symptoms.