Bone marrow involvement in a female Egyptian patient with sarcoidosis: a rare case report with a brief literature review

Abstract

Sarcoidosis is a complex systemic disorder characterized by the formation of non-caseating granulomas in multiple organs. Involvement of the bone marrow in sarcoidosis is very rare, making diagnosis challenging. This case study highlights the challenges of diagnosing sarcoidosis, which was detected primarily through bone marrow involvement, and discusses the associated clinical consequences. We treated a 63-year-old woman with symptoms including persistent worsening anemia and leukopenia, and intermittent subtle respiratory issues. These symptoms prompted further medical evaluations. Comprehensive evaluation led to a diagnosis of Sarcoidosis with bone marrow involvement. The initial treatment protocol included oral prednisolone. Following initiation of treatment, the patient became afebrile and demonstrated significant clinical and hematological improvement. Bone marrow involvement in sarcoidosis often presents as cytopenias, mainly anemia, leukopenia, and lymphopenia. It is frequently associated with both pulmonary and extrapulmonary symptoms, although rare cases may be the first sign. Emphasizing a comprehensive approach—including detailed clinical evaluation and ongoing monitoring—is critical for effective management, particularly after excluding other malignant and reactive granulomatous diseases.