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When sarcoidosis mimics immunodeficiency
  1. Navneet Kaur,
  2. Anand Kumthekar and
  3. Bibi Ayesha
  1. Rheumatology, Montefiore Medical Center, Bronx, New York, USA
  1. Correspondence to Dr Navneet Kaur; navneetdr85{at}


Sarcoidosis is a granulomatous disease with a wide spectrum of clinical manifestations. A 28-year-old previously healthy woman presented with multifocal pneumonia, mediastinal lymphadenopathy which was thought to be caused by actinomyces infection. Despite antibiotics, she developed cavitary lung lesions and had worsening lymphadenopathy prompting evaluation for alternative aetiologies like malignancy, autoimmune or immunodeficiency disorders. Further workup also revealed low CD4, CD8 cell counts, elevated soluble interleukin-2 levels. Over the due course of time, she developed granulomatous pan-uveitis, classical skin lesions leading to the diagnosis of sarcoidosis. Our case highlights the rare manifestations of sarcoidosis which can mimic immunodeficiency disorders especially when these patients develop secondary infections. Our goal is to raise awareness among clinicians about these atypical presentations of sarcoidosis which can lead to substantial delay in diagnosis thus leading to progression of the disease in the absence of appropriate treatment.

  • immunology
  • interstitial lung disease
  • connective tissue disease

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  • Contributors NK, AK and BA were actively involved in drafting and editing this manuscript. In addition, BA is providing medical care to this patient in the clinic.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.