Concurrent sarcoidosis and hemophagocytic lymphohistiocytosis: A case report

Table 1 Laboratory examinations during the patient’s disease course

Liver function test	Reference range/Unit	August 31, 2025	September 13, 2025	December 14, 2025
Total bilirubin	< 21.0 μmol/L	7.00	9.30	7.03
Direct bilirubin	≤ 5.0 μmol/L	4.54	5.60	4.13
Alkaline phosphatase	35-104 U/L	220	212	120
Alanine aminotransferase	< 35 U/L	22.9	15.60	31.60
Aspartate aminotransferase	< 35 U/L	28.50	21.00	18.30
Albumin	35.0-52.0 g/L	37.00	37.10	40.70
Protein	64-83 g/L	84.60	70.20	71.20
Complete blood count	Reference range/unit	September 13, 2025	January 4, 2026	March 18, 2026
Hematocrit	37%-47%	24.3	35.4	34.7
Nucleated red blood cells	0-0.6/100 WBC	0.2	0.1	0.1
Red cell distribution width	12.1%-16.2%	18.2	20.2	15.8
Mean platelet volume	7.4-11.4 fL	8.6	8.7	9.1
Basophils	0-0.1 × 103/μL	0.0	0.0	0.0
Eosinophils	0-0.5 × 103/μL	0.1	0.0	0.0
Hemoglobin	12.5-16.3 g/dL	7.6	11.3	11.6
Lymphocytes	1-3.2 × 103/μL	0.6	2.00	1.0
Mean corpuscular hemoglobin	23.8-33.4 pg	24.6	24.6	29.2
Mean corpuscular hemoglobin concentration	32.5-36.3 g/dL	31.3	31.8	33.5
Mean corpuscular volume	73.0-96.2 fL	78.4	77.3	87.2
Monocytes	0.3-1.10 × 103/μL	0.4	0.3	0.1
Neutrophils	1.70-7.60 × 103/μL	2.00	4.80	3.9
Platelet count	150-410 × 103/μL	138	110	101
Red cell count	4.06-5.63 × 103/μL	3.11	4.58	3.97
White cell count	3.6-10.2 × 103/μL	3.1	7.2	5.1
Additional hematological tests. Absolute reticulocyte count (August 31, 2025). Absolute reticulocyte count (December 14, 2025)	39-57 × 109/L; 39-57 × 109/L	97; 84
Prothrombin time	11.7-15.3 seconds	14.5
International normalized ratio	0.80-1.20	1.08
Activated partial thromboplastin time	28.6-40.0 seconds	37.8
Other laboratory tests	Reference range	Result
Procalcitonin	< 0.05 mg/mL	0.17-0.52
Ferritin	30-250 ng/mL	425
D-dimer	0.27-0.60 µg/mL	2.05
Angiotensin-converting enzyme	20-70 U/L	75.7
Leishmania screening	Negative	Negative
Viral serology	Negative	Negative
Malarial antigen (Plasmodium falciparum)	Negative	Negative
Parvovirus B19 IgG and IgM	Negative	IgG positive: 29.4 IU/mL; IgM negative
QuantiFERON-TB gold test	Negative	Negative

WBC: White blood cell; IgG: Immunoglobulin G; IgM: Immunoglobulin M.