Differentiating pulmonary sarcoidosis from pulmonary tuberculosis in clinical practice: Insights from routine blood...

Pulmonary sarcoidosis and pulmonary tuberculosis are both diseases that affect hundreds of thousands of people worldwide. Because both present with granulomatous inflammation in clinical practice, distinguishing tuberculosis from sarcoidosis can be difficult. This study hypothesised that parameters, such as monocyte, and albumin levels, and red blood cell distribution width and mean platelet volume ratio, can help differentiate sarcoidosis from tuberculosis.

We included 203 patients with sarcoidosis and 200 with tuberculosis in the study after excluding those with misdiagnoses or insufficient data. The neutrophil-lymphocyte ratio and platelet-lymphocyte ratio were obtained by dividing neutrophil and platelet levels by lymphocyte count. The blood parameters belong to the period of the first diagnosis before starting a treatment.

The sarcoidosis group had higher levels of mean platelet volume, platelet distribution width, and albumin, whereas they had lower levels of red blood cell distribution width, red blood cell distribution width/platelet distribution width, and red blood cell distribution width/mean platelet volume. Levels above 42.95 g/L for albumin and below 3.72 g/L for red blood cell distribution width/platelet distribution width promote sarcoidosis.

Lower monocyte levels, red blood cell distribution width, red blood cell distribution width/platelet distribution width, and red blood cell distribution width/mean platelet volume, along with higher levels of mean platelet volume, platelet distribution width, platelets, albumin, and lymphocyte-monocyte ratio, may favour sarcoidosis over tuberculosis.