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January 18, 1980

Severe Thrombocytopenia and Sarcoidosis

Author Affiliations

From the Department of Internal Medicine (Dr Knodel) and the Pulmonary Disease Service (Dr Beekman), Madigan Army Medical Center, Tacoma, Wash.

JAMA. 1980;243(3):258-259. doi:10.1001/jama.1980.03300290040021

SEVERE thrombocytopenia is a rare manifestation of sarcoidosis, with only 24 cases and six deaths, including the patient described here, reported. Severe thrombocytopenia in sarcoidosis is most probably secondary to an immune process leading to increased peripheral destruction. Treatment consists of correction of the platelet deficiency and use of corticosteroids.

Report of a Case  A 23-year-old woman was asymptomatic until four days prior to admission, when she had the onset of cough, sore throat, and rhinitis. In the ensuing three days, she noted easy bruisability, epistaxis, and, one day prior to admission, a petechial rash. On the day of admission, she experienced an acute bifrontal headache and became increasingly lethargic. She denied history of chronic cough, exercise intolerance, lymphadenopathy, prior skin rash, fevers, weight change, fatigue, malaise, or bleeding dyscrasias.At the time of admission, her temperature was 37.5 °C; pulse rate, 130 beats per minute; blood pressure, 120/90 mm