LEFGRENA SYNDROME (S. H. Lofgren, sovr, Swedish therapist; synonym: bilateral root syndrome, syndrome of a bilateral gilyusny lymphoma, high-quality cryptogenic mediastinal adenopathy) — the symptom complex which is characterized by damage of skin as a knotty erythema in combination with increase in radical pulmonary lymph nodes.
The etiology and a pathogeny
Is supposed a bacterial (streptococcal) or viral infection, existence of an allergic component is not excluded. In literature there is an opinion that the syndrome is manifestation of an acute mediastinal and pulmonary sarcoidosis with nonspecific damage of skin.
Patogistologiya: in nodes of skin at an early stage of Hp the acute inflammation in a mesh layer of a derma and a hypoderma with the infiltrate containing lymphocytes, neutrophils and histiocytes is observed, at later stage infiltrate consists of epithelial cells, Langkhans's cells and lymphocytes. There is no description of pato-histology pulmonary limf, nodes in literature.
A clinical picture
adults, preferential women Are ill more often. Hp is characterized by the acute beginning, proceeds in most cases is good-quality and usually completely regresses in all the manifestations within several weeks, is more rare than months.
The disease is shown by a knotty erythema (inflammatory painful nodes from 1 to 6 cm) usually on the lower extremities, bilateral massive symmetric increase paratracheal and bronkhopulmonalny limf, nodes and disturbance of the general condition of the patient: fever, weakness, slackness, arthralgias, mialgiya, headaches, arching pains behind a breast. The eosinophilia, a monocytosis raised by ROE, increase alpha and gamma-globulins is noted.
Diagnosis it is put on the basis of manifestations, characteristic of a knotty erythema, on skin, increases bronkhopulmonalny limf, the nodes defined radiological. The differential diagnosis is carried out with tuberculosis limf, nodes (see. Lymphadenitis ), lymphogranulomatosis (see); elements of a knotty erythema differentiate with indurative tuberculosis cutis (see), a knotty periarteritis (see. Periarteritis nodular ). Tuberkulinovy tests, as a rule, negative, are more rare slabopolozhitelny.
is Appointed by Prednisolonum, dexamethasone, Triamcinolonum (in a daily dose of 20 — 30 mg in terms of Prednisolonum), antibiotics (penicillin, erythromycin, Oletetrinum, etc. to 1 million. Piece a day), vitamins (Ascorutinum, etc.); outwardly corticosteroid ointments (Synalarum, Flucinarum, locacortenum), compresses from 10% glyceric solution of Ichthyolum.
Forecast favorable — full treatment in several weeks or months.
Prevention is not developed.
Bibliography: Antonov V. A., Moshchenko V. S. and Antonov G. K. About Lefgren's syndrome, Rubbed. arkh., t. 48, No. 8, page 148, 1976; Makarenko V. N. and, river. Case of a syndrome of Lefgren, Vestn, dermas, and veins., No. 8, page 77, 1976; Sh and p about sh N and - to about in O. K. Chronic knotty erythema, L., 1971. bibliogr.; H lig e W., Hiige H. Zaumseil J. Zur Klinik und Therapie des Lofgren-Syndroms, Dtsch. Gesundh. - Wes., Bd 29, S. 1689, 1974, Bibliogr.; Kerley P Etiology of erythema nodosum, Brit. J. Radiol., v. 16, p. 199, 1943; Lofgren S. Erythema nodosum. Acta med. scand., suppl. 174, p. 1, 1946; Lofgren S. Lund-back H. The bilateral hilar lymphoma syndrome, ibid., v. 142, p. 265. 1952.
A. A. Antonyev.