Sarcoidosis of blood elements

Sarcoidosis is a multisystem disease of unknown cause. It most often affects young and middle-aged people. It is often manifested by bilateral hilar adenopathy, pulmonary infiltrates, ocular and skin lesions. The liver, spleen, lymph nodes, salivary glands, heart, nervous system, muscles, bones and other organs can also be affected. Haematological abnormalities may also be present.

Epidemiology
Anemia occurs in 4-20 % of patients. Leukopenia is present in 40 % of patients. Lymphopenia affects 10-26 % of patients.

Symptoms
Leukopenia is rarely severe. If splenomegaly is not present, it may indicate bone marrow involvement. It is most often caused by the redistribution of T-lymphocytes to the sites of involvement.

Lymphopenia is due to redistribution and expansion of dysfunctional regulatory T cells (Treg). This group of patients appears to be highly responsive to TNF therapy.

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