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We report a 69 year-old female with sarcoidosis who developed chronic thrombocytopenia, a rare complication of this disorder. Histologically normal bone marrow with increased number of megakaryocytes and high level of PAIgG strongly suggest the immune destruction of platelets as the cause of thrombocytopenia. In addition to thrombocytopenia, this case is also distinctive in its clinical manifestation. The patient developed several infrequent manifestations of sarcoidosis including complete AV block, uveitis, skin eruptions and middle lobe syndrome, but, did not have an intrathoracic adenopathy, the commonest manifestation of this disease.
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