To the Editor: Drs Iannuzzi and Fontana introduced their Grand Rounds with an unusual case of sarcoidosis, a woman who also had thrombocytopenia.1 Thrombocytopenia is a rare extrapulmonary complication of sarcoidosis, even in the presence of splenomegaly.2 It is most often represented in the literature in case reports and series. In one review, thrombocytopenia was reported in less than 2% of patients with documented sarcoidosis.2 Splenic involvement with sarcoidosis is relatively more common; splenomegaly detectable on physical examination, which the patient demonstrated, has been reported in approximately 5% to 18% of unselected patients,2,3 and up to 33% of all patients demonstrate splenomegaly on abdominal imaging, with or without associated nodules.3,4
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