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Paul McCabe, Surabhi Wig, Galaxy sign in alveolar sarcoidosis: An unusual radiological presentation of Lofgren’s syndrome, Rheumatology, Volume 56, Issue 12, December 2017, Page 2128, https://doi.org/10.1093/rheumatology/kex359
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Extract
A 27-year-old Caucasian woman presented in February 2017 with a 4-week history of symmetrical joint pain and swelling involving the ankles and knees, rash on lower limbs consistent with erythema nodosum and intermittent chest pain. No environmental triggers were identified. A chest radiograph revealed bilateral symmetrical hilar lymphadenopathy, and some atypical ill-defined air space opacities were seen in the right upper lobe (Fig. 1A). Blood tests demonstrated CRP of 199.5 mg/l (normal <5 mg/l) and serum angiotensin converting enzyme levels were 76 IU/l (normal 20–70 IU/l). A diagnosis of Lofgren’s syndrome was made. Subsequent high-resolution CT confirmed bilateral hilar lymphadenopathy and also demonstrated the galaxy sign typical of alveolar sarcoidosis (Fig. 1B). The patient made a good clinical and radiological recovery with low dose oral prednisolone, and a follow-up chest X-ray 5 months after the initial presentation showed an almost complete resolution of the atypical pulmonary opacities and improvement of the hilar lymphadenopathy
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