American Board of Internal Medicine (ABIM) Certification Practice Exam

Which medication is commonly used to treat Löfgren syndrome?

1. Adalimumab

2. Hydroxychloroquine

3. Naproxen

4. Tofacitinib

The correct answer is: Naproxen

Löfgren syndrome, a form of sarcoidosis characterized by a specific set of symptoms, including erythema nodosum, bilateral hilar lymphadenopathy, and fever, is often treated with nonsteroidal anti-inflammatory drugs (NSAIDs). Naproxen, a widely used NSAID, provides symptomatic relief by reducing inflammation and pain associated with this condition. NSAIDs like naproxen work by inhibiting the cyclooxygenase enzymes (COX-1 and COX-2), which in turn decreases the production of prostaglandins, substances that mediate inflammation and pain. Since Löfgren syndrome can present with significant inflammatory symptoms, using naproxen could help alleviate discomfort and improve the patient's quality of life. Other medications listed, such as adalimumab and tofacitinib, are generally utilized in more severe or refractory cases of sarcoidosis or other autoimmune disorders. Hydroxychloroquine is primarily used for conditions such as lupus and malaria rather than Löfgren syndrome specifically, where the first-line treatment often centers on NSAIDs. Thus, naproxen is the most common and appropriate medication to manage the symptoms associated with Löfgren syndrome.