Can neutrophil/lymphocyte ratio and platelet/lymphocyte ratio be used in differential diagnosis of Stage I sarcoidosis from tuberculosis lymphadenopathy?

Abstract

OBJECTIVE: It is challenging to differentiate mediastinal lymph node enlargement caused bytuberculosis (TB) and sarcoidosis as both diseases may cause granulomatous inflammation.The objective of this study is to evaluate the use of neutrophil/lymphocyte ratio (NLR) andplatelet/lymphocyte ratio (PLR) as possible markers in the differential diagnosis of Stage I sarcoidosisand TB lymphadenopathy in patients who present with mediastinal lymph nodes and no parenchymalinvolvement.MATERIALS AND METHODS: A total of 19 TB, 55 sarcoidosis, and 32 control patients, whose clinicalrecords were available, were included in this retrospective study. All patients had a granulomatousreaction revealed on their lymph node biopsy specimen. The complete blood count at the time ofdiagnosis was included in the study.RESULTS: NLR and PLR were both significantly increased in Stage 1 sarcoidosis patients comparedto controls while only PLR was significantly increased in the TB group (for sarcoidosis, NLRP < 0.001 and PLR P < 0.001; for TB, NLR P = 0.12; PLR P = 0.017). There were neither significantdifferences in serum NLR nor PLR between sarcoidosis and TB groups.CONCLUSION: Although NLR and PLR are useful tools to differentiate Stage 1 sarcoidosis fromcontrols and PLR may be used to differentiate TB lymphadenopathy from controls, these parametersmay not be used to differentiate between Stage 1 sarcoidosis and TB lymphadenopathy.