Value of neutrophil/lymphocyte ratio in the differential diagnosis of sarcoidosis and tuberculosis
Open accessAbstract
INTRODUCTION: The differential diagnosis of sarcoidosis creates a challange due to tuberculosis also having lung and lymph node involvement. Because both diseases show granulomatous inflammation, it may not be possible to distinguish tuberculosis and sarcoidosis in pathological specimens. As a result of the complexity in the differential diagnosis of sarcoidosis and tuberculosis, new markers for differentiation are being investigated. OBJECTIVE: The aim of our study is to investigate the value of neutrophil/lymphocyte ratio (NLR) as a possible marker in differentiating sarcoidosis and tuberculosis. MATERIALS AND METHODS: In our study, 51 acid-fast bacilli (AFB) positive and/or culture-positive patients with pulmonary tuberculosis, 40 patients with biopsy-proven sarcoidosis and a control group consisting of 43 patients were included. In our study, information was collected retrospectively based on hospital records. RESULTS: Leukocyte and neutrophil counts, NLR, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) were significantly higher, and albumin was significantly lower in the tuberculosis group compared with sarcoidosis (for all parameters P < 0.001). The most appropriate cut-off value of NLR to distinguish tuberculosis from sarcoidosis was determined as 2.55. For this cut-off value of NLR there was 79% sensitivity, 69% specificity, 73% positive predictive value (PPV), 75% negative predictive value (NPV), and area under the curve (AUC) was 0.788. For differentiation of sarcoidosis from tuberculosis, accuracy of the NLR test according to this cut-off value was found as 76%. CONCLUSION: NLR as a little known marker in respiratory medicine was found to be supportive in differentiation of tuberculosis and sarcoidosis. More studies on this issue is needed.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The neutrophil to lymphocyte ratio and platelet to lymphocyte ratio are significantly higher in TB compared to sarcoidosis, providing a non-invasive diagnostic aid.
“The neutrophil to lymphocyte ratio and platelet to lymphocyte ratio have been investigated as potential biomarkers. These markers are significantly higher in TB compared to sarcoidosis, providing a non-invasive diagnostic aid [58].”
From Head and Neck Tuberculosis: A Rare Diagnosis and the Role of Surgical Biopsy and Histopathological Evaluation in Extrapulmonary Disease (2025) · cites this paper as [58]
The Discussion (page unavailable) reports that an NLR cutoff of 2.55 distinguished tuberculosis from sarcoidosis with 76% accuracy, supporting its potential as a diagnostic aid. Our copy does not report a platelet-to-lymphocyte ratio finding for these groups, and the passages do not establish that NLR was significantly higher in tuberculosis than in sarcoidosis; the stated significant elevations compare each group with controls. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Zahorec, R. (2001) · Bratislava Medical Journal · doi:10.1007/bf03656390 · Cited by 1,601 · see citing works
Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer
Walsh, S. R., Cook, E. J., Goulder, F., Justin, T. A., & Keeling, N. J. (2005) · Journal of Surgical Oncology · doi:10.1002/jso.20329 · Cited by 1,121 · see citing works
Tamhane, U. U., Aneja, S., Montgomery, D. G., Rogers, E. D. W. W., Eagle, K. A., & Gurm, H. S. (2008) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2008.05.006 · Cited by 902 · see citing works
Sarraf, K. M., Belcher, E., Raevsky, E., Nicholson, A. G., Goldstraw, P. G., & Lim, E. K. S. (2008) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2008.05.046 · Cited by 554 · see citing works
Núñez, J. E., Núñez, E., Bodı́, V., Sanchís, J. M., Miñana, G., Mainar, L., Santas, E., Merlos, P., Rúmiz, E., Darmofal, H., et al. (2008) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2007.11.004 · Cited by 510 · see citing works
Halazun, K. J., Aldoori, A. Q., Malik, H. M. A., Al-Mukhtar, A., Prasad, R. K., Toogood, G. J., & Lodge, J. P. A. (2007) · European Journal of Surgical Oncology · doi:10.1016/j.ejso.2007.02.014 · Cited by 444 · see citing works
Duffy, B., Gurm, H. S., Rajagopal, V., Gupta, R., Ellis, S. G., & Bhatt, D. L. (2006) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2005.10.034 · Cited by 418 · see citing works
The Neutrophil-Lymphocyte Count Ratio in Patients with Community-Acquired Pneumonia
de Jager, C. P. C., Wever, P. C., Gemen, E. F. A., Kusters, R., van Gageldonk‐Lafeber, A. B., van der Poll, T., & Laheij, R. J. F. (2012) · PLoS ONE · doi:10.1371/journal.pone.0046561 · Cited by 333 · see citing works
Turkmen, K., Erdur, F. M., Ozcicek, F., Ozcicek, A., Akbas, E. M., Ozbicer, A., Demirtas, L., Turk, S., & Tonbul, H. Z. (2013) · Hemodialysis International · doi:10.1111/hdi.12040 · Cited by 309 · see citing works
Cedrés, S., Torrejon, D. Y., Martínez‐Martí, A., Martínez, P., Navarro, A., Zamora, E., Mulet-Margalef, N., & Felip, E. (2012) · Clinical & Translational Oncology · doi:10.1007/s12094-012-0872-5 · Cited by 292 · see citing works
Depression of Cellular Immunity after Multiple Trauma in the Absence of Sepsis
OʼMAHONY, J. B., Palder, S. B., Wood, J. J., McIrvine, A., Rodrick, M. L., Demling, R. H., & Mannick, J. A. (1984) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/00005373-198410000-00001 · Cited by 218 · see citing works
Neutrophil-to-Lymphocyte Ratio in Chronic Obstructive Pulmonary Disease: A Retrospective Study
Günay, E., Ulaşlı, S. S., Akar, O., et al. (2013) · Inflammation · doi:10.1007/s10753-013-9749-1 · Cited by 209 · see citing works
Regulation of Adhesion Molecules during Human Endotoxemia: No Acute Effects of Aspirin
Jilma, B., Blann, A. D., Pernerstorfer, T., et al. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.159.3.9805087 · Cited by 199 · see citing works
Yoon, N.-B., Son, C., & Um, S. (2013) · Annals of Laboratory Medicine · doi:10.3343/alm.2013.33.2.105 · Cited by 185 · see citing works
As a New Inflammatory Marker for Familial Mediterranean Fever: Neutrophil-to-Lymphocyte Ratio
Ahsen, A., Ulu, M. S., Yüksel, Ş., Demir, K., Uysal, M., Erdoğan, M. Ö., & Acartürk, G. (2013) · Inflammation · doi:10.1007/s10753-013-9675-2 · Cited by 150 · see citing works
Inflammation-Based Prognostic Indices in Malignant Pleural Mesothelioma
Pinato, D. J., Mauri, F. A., Ramakrishnan, R., Wahab, L., Lloyd, T., & Sharma, R. (2012) · Journal of Thoracic Oncology · doi:10.1097/jto.0b013e31823f45c1 · Cited by 147 · see citing works
Effects of surgical trauma of laparoscopic vs. open cholecystectomy.
Dionigi, R., Dominioni, L., Benevento, A., et al. (1994) · PubMed · Cited by 83 · see citing works
Health-related quality of life and inflammatory markers in malignant pleural mesothelioma
Kao, S., Vardy, J. L., Harvie, R. M., et al. (2012) · Supportive Care in Cancer · doi:10.1007/s00520-012-1569-6 · Cited by 49 · see citing works
Idiopathic Granulomatosis Manifesting as Fever of Unknown Origin
Telenti, A., & Hermans, P. E. (1989) · Mayo Clinic Proceedings · doi:10.1016/s0025-6196(12)65302-6 · Cited by 31 · see citing works
DEPRESSION OF CELLULAR IMMUNITY AFTER MULTIPLE TRAUMA IN THE ABSENCE OF SEPSIS
Jb, O., Palder, S. B., Ml, R., et al. (1983) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/00005373-198307000-00130 · Cited by 19 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Mogoantă, C. A., Osman, A., Georgescu, A.-M., Mitroi, A. M., Busuioc, C. I., Tănase, I., Cioboată, R., Liliac, I. M., Cimpeanu, O. L., & Ciolofan, M. S. (2025) · Pathogens · doi:10.3390/pathogens14050479 · Cited by 2 · see citing works
“These markers are significantly higher in TB compared to sarcoidosis, providing a non-invasive diagnostic aid [58].”
- Authors
- Iliaz, S., Iliaz, R., Ortakoylu, G., Bahadir, A., Bagci, B., & Caglar, E.
- Venue
- Annals of Thoracic Medicine
- Published
- 2014
- Volume
- 9
- Issue
- 4
- Pages
- 232
- ISSN
- 1817-1737 (ISSN-L)
- PMC
- PMC4166071
- OpenAlex
- W2043714428
- Cited by
- 89
- References
- 20
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 9 · 2023: 10 · 2022: 4 · 2021: 11 · 2020: 7 · 2019: 7 · 2018: 8 · 2017: 9 · 2016: 7 · 2015: 8
- FWCI
- 5.32
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Annals of Thoracic Medicine (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Physiology › Sarcoidosis and Beryllium Toxicity Research
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Keywords
- neutrophil-to-lymphocyte ratio, sarcoidosis, pulmonary tuberculosis, differential diagnosis, granulomatous inflammation, inflammatory markers, cut-off values, diagnostic accuracy, erythrocyte sedimentation rate, C-reactive protein
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
