{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T08:05:18Z","timestamp":1781078718156,"version":"3.54.1"},"reference-count":17,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>L\u00f6fgren\u2019s syndrome is an acute variant of sarcoidosis, characterized by the classic triad of erythema nodosum, bilateral hilar lymphadenopathy, and arthralgia or arthritis. Its low incidence in the Chinese population contributes to limited clinical awareness and diagnostic challenges. We report the case of a Chinese man with long-standing ankylosing spondylitis who had been experiencing recurrent joint swelling, pain, and fever over the past year. At the most recent presentation, he had developed tender, erythematous subcutaneous nodules on the limbs, clinically consistent with erythema nodosum, and was diagnosed with ankylosing spondylitis and L\u00f6fgren\u2019s syndrome. A comprehensive review of his treatment course revealed a favorable response to glucocorticoid therapy. Notably, he had received adalimumab for ankylosing spondylitis over the past year, and the temporal relationship suggested that adalimumab precipitated L\u00f6fgren\u2019s syndrome relapse. We further reviewed the literature comparing L\u00f6fgren\u2019s syndrome between Western and Asian populations. Our findings indicate that Asian L\u00f6fgren\u2019s syndrome patients are more likely to receive a delayed diagnosis and often require lengthier glucocorticoid therapy. These differences may stem from genetic predispositions influencing disease expression and immune response. Therefore, we recommend that glucocorticoid regimens for L\u00f6fgren\u2019s syndrome in Chinese patients be carefully titrated and monitored. In a similar manner, when L\u00f6fgren\u2019s syndrome coexists with other rheumatic immune diseases, tumor necrosis factor-\u03b1 inhibitors such as adalimumab should be used with heightened vigilance to minimize disease relapse.<\/jats:p>","DOI":"10.1177\/03000605261454042","type":"journal-article","created":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T06:55:30Z","timestamp":1780815330000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic and therapeutic challenges in a patient with coexisting ankylosing spondylitis and L\u00f6fgren\u2019s syndrome: A case report"],"prefix":"10.1177","volume":"54","author":[{"given":"Limin","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanling","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Third People\u2019s Hospital of YuHang District, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liu","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hangzhou TCM Hospital Zhejiang Chinese Medical University, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9463-8256","authenticated-orcid":false,"given":"Ling","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Rheumatology, The Third People\u2019s Hospital of YuHang District, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,6]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2016.03.004"},{"key":"e_1_3_7_3_2","volume-title":"StatPearls","author":"Brown F","year":"2025","unstructured":"Brown F, Modi P, Tanner LS. 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A case of sarcoidosis presenting with arthritis as the initial symptom. Rheumatism and Arthritis 2016; 5: 63\u201365.","journal-title":"Rheumatism and Arthritis"},{"key":"e_1_3_7_15_2","first-page":"120","article-title":"A case of L\u00f6fgren\u2019s syndrome presenting with erythema nodosum as the initial symptom","volume":"23","author":"Sun RR","year":"2019","unstructured":"Sun RR, Yu SB, Wang J, et\u00a0al. A case of L\u00f6fgren\u2019s syndrome presenting with erythema nodosum as the initial symptom. 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