Löfgren’s syndrome: ureaplasmal association questioned

Excerpt

The report by López-Gómez et al. [1] of sarcoidosis characterized by erythema nodosum, bilateral hilar lymphadenopathy and arthritis (Löfgren’s syndrome) together with urethritis, in which the authors claimed that the latter was due to Ureaplasma urealyticum does, I believe, deserve comment. The clinical description indicates that the patient had sarcoidosis, but whether the concomitant urethritis was due to Ureaplasma urealyticum is not clear for various reasons. Bacteriological culture of urine was said to be normal, but whether tests were undertaken for Chlamydia trachomatis and Mycoplasma genitalium, the latter also now recognised as a cause of non-gonococcal urethritis [2], was not mentioned. Detection of the ureaplasma by ‘tissue culture’ seems irregular, and indisputable evidence for it being a urea-metabolising microorganism was not given. In addition, there was no indication of the number of organisms detected, nor was there an indication of whether the ureaplasma truly belonged to the species Ureaplasma urealyticum, which has been associated with non-gonococcal urethritis [3, 4], or whether it might have been Ureaplasma parvum [5], which has not. Differentiation between the two species is not possible without resorting, for example, to polymerase chain reaction technology [6]. …