M. C. SWEATMAN, M.B., M.R.C.P.; R. WILSON, M.B., M.R.C.P.; D. N. MITCHELL, M.D., M.R.C.P.
To the editor: We report the case of a patient with sarcoidosis and macrocytic anemia attributable to megaloblastic changes in a bone marrow infiltrated by typical sarcoid granulomas. Extensive investigation failed to reveal any other cause for her megaloblastic anemia.
A 41-year-old white woman presented with lethargy, breathlessness, and weight loss. Physical findings included jaundice, bruising, ankle edema, and hepatosplenomegaly. Laboratory studies showed hemoglobin, 6.4 g/dL; erythrocyte count, 1.96 X 1012/L; mean cell volume, 101 fL; leukocyte count, 1.7 X 109/L; platelets, 87 X 109/L; and reticulocytes, 0.8%. A blood film showed macrocytosis, anisocytosis, poikilocytosis, and hypersegmented neutrophils. The clotting
SWEATMAN MC, WILSON R, MITCHELL DN. Megaloblastic Anemia in Sarcoidosis. Ann Intern Med. ;104:129. doi: 10.7326/0003-4819-104-1-129_1
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Published: Ann Intern Med. 1986;104(1):129.
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