Common variable immune deficiency (CVID) may be misdiagnosed as sarcoidosis when noncaseating granulomas are the initial manifestation.
Situation: non-caseating granulomas
Risk factors for misdiagnosis of sarcoidosis:
(1) evolution of the underlying disease over time
(2) failure to completing exclude alternative diagnoses for noncaseating granulomas
(3) elevated ACE levels
(4) bilateral hilar lymphadenopathy
Clues to CVID:
(1) immunodeficiency rather than polyclonal gammopathy
(2) autoimmune disorder including ITP
(3) repeated or unusual infections
(4) onset of symptoms in childhood (although can appear into middle age)
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Specialty: Immunology/Rheumatology
