%0 Journal Article %A Ratna Alluri %A David Miller %A Anne-Marie Shanks %A Richard Herriot %A Owen Dempsey %T Uncommonly common? Common variable immunoglobulin deficiency 'masquerading' as sarcoidosis %D 2012 %J European Respiratory Journal %P P3674 %V 40 %N Suppl 56 %X Introduction:Multisystem granulomatous inflammation can be a presenting feature or a complication of common variable immune deficiency (CVID).A proportion of patients diagnosed with 'sarcoidosis' may actually have underlying CVID, recognition of which may be associated with considerable diagnostic delay.Method: 2 cases are presented to illustrate this along the results of an audit.Case 1 LC presented aged 28 with chronic cough and deranged LFTs. HRCT showed multiple pulmonary nodules and generalised lymphadenopathy.Granulomas were seen on liver biopsy.A diagnosis of sarcoidosis was made.4 years later after several chest infections, severe panhypogammaglobulinemia was demonstrated and a revised diagnosis of CVID made.Case 2 DG presented aged 29 with cough, breathlessness and generalised lymphadenopathy with bilateral hilar lymphadenopathy on chest x-ray.Sarcoidosis was diagnosed after lymph node aspirate demonstrated granulomata.13 years later, investigations after a protracted pneumonia revealed panhypogammaglobulinemia.Standard immunoglobulin replacement therapy at a dose of 400mg/kg/month was started in both cases after the diagnosis of CVID.An audit of our cohort of 148 patients with diagnosed sarcoidosis found that 47% had not had serum immunoglobulins checked during diagnostic work-up.Conclusion: Chest physicians often omit to check immunoglobulins when assessing patients with suspected sarcoidosis.This may not be surprising given the lack of advice on measurement of immunoglobulins in current Interstitial Lung Disease guidelines. While CVID is uncommon, awareness, early diagnosis and effective treatment can reduce morbidity, mortality and complications and improve quality of life. %U https://erj.ersjournals.com/content/erj/40/Suppl_56/P3674.full.pdf