The simultaneous presentation of sarcoidosis and common variable immune deficiency

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