Recurrent sarcoidosis

A 39-year-old woman was admitted with symptoms of erythema nodosum. A chest film showed right paratracheal and hilar bilateral lymphadenopathy and basal lung infiltrates. The diagnosis of subacute sarcoidosis was made despite the lack of histological proof. The disorder resolved spontaneously in a few months. Five years later Löfgren syndrome reappeared with cutaneous nodules, a biopsy of which showed noncaseating epithelioid granulomas. The Kveim test was positive. All features showed progressive regression without treatment. Four years later the patient presented right paratracheal and bilateral hilar lymph nodes and cutaneous nodules, and a biopsy again showed noncaseating granulomas. Spontaneous regression ensued and in the last four years she has remained symptom-free.