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Arch Pediatr Adolesc Med. 1998;152:1037.

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The notable report by Zsolway et al¹ about pediatric sarcoid beautifully illustrates how elusive this diagnosis can be. When performed, the test for angiotensin-converting enzyme can be very helpful. There is a more routine laboratory test that can flag the presence of granulomatous inflammation, and that is a differential cell count which reveals a relative monocytosis. This evidence is present in case 2; values for the differential cell count are not described in case 1 but would certainly be interesting. In the absence of bone marrow problems or laboratory error, the monocyte count can be most valuable in puzzling cases of inflammation.

Carl F. Needles, MD
1955 Merrick Rd
Merrick, NY 11566

1. Zsolway K, Sinai LN, Magnusson M, Tunnessen WW Jr. Two unusual pediatric presentations of sarcoidosis. Arch Pediatr Adolesc Med. 1998;152:410-411. FREE FULL TEXT

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In review of the laboratory data for the patient in case 1, there was indeed a relative monocytosis with 0.09 monocytes noted on the peripheral smear.¹ Dr Needles' point that a relative monocytosis can be a . . . [Full Text of this Article]

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