The simultaneous presentation of sarcoidosis and common variable immune deficiency

Sarcoidosis and common variable immune deficiency can rarely present simultaneously in the same individual. We describe a child who presented with both disorders. The diagnosis of sarcoidosis was delayed because of the atypical appearances of the liver biopsy. She failed to respond to intravenous immunoglobulin but improved once cyclosporin and corticosteroids were added to her treatment regimen. It is important that the co-existence of both disorders is recognised so that treatment with a combination of intravenous immunoglobulin and immunosuppression can be in instituted to treat both the immune deficiency as well as the granulomatous disorder. As illustrated here, patients may fail to respond if either modality is used alone.