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A woman in her mid-40s presented with progressive shortness of breath, high-protein ascites, omental thickening and hypercalcaemia. Initially suspected to have disseminated tuberculosis (TB), the patient did not respond to the antitubercular therapy. Further evaluation revealed non-caseating granulomas on omental biopsy and elevated serum Angiotensin- Converting Enzyme (ACE) levels, confirming the diagnosis of sarcoidosis. This case highlights a diagnostic dilemma between sarcoidosis and TB, particularly in regions with high disease prevalence. This underscores the importance of integrating the clinical, radiological and histopathological findings for accurate diagnosis and management.
Garg et al. (Fri,) studied this question.