Acute respiratory failure in a patient with sarcoidosis and immunodeficiency - An unusual presentation and a complicated course

Adi Leiba, Sara Apter, Merav Leiba, Michael Thaler, Ehud Grossman

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Pulmonary sarcoidosis is usually a chronic, insidious disease resulting from granuloma formation in the lung parenchyma. The epithelioid non-caseating granulomata of sarcoidosis are the result of a T-helper1-mediated immune reaction to an unknown self or foreign antigen. We describe the case of a patient with sarcoidosis and a coexistent common variable immunodeficiency who presented with rapidly progressive respiratory failure. This unusual presentation was followed by a complicated course with recurrent pneumoccocal infections, which could be explained by the coexistence of common variable immunodeficiency. Physicians should be alert to the possibility of sarcoidosis even when the clinical presentation is of acute respiratory distress syndrome (ARDS) since early treatment with steroids can be lifesaving. The detection of accompanying hypogammaglobulinemia is also crucial, as treatment with intravenous immunoglobulins (IVIG) together with steroids can improve the patient's outcome.

Original languageEnglish
Pages (from-to)73-77
Number of pages5
JournalLung
Volume182
Issue number2
DOIs
StatePublished - 10 May 2004
Externally publishedYes

Keywords

  • Acute respiratory distress syndrome
  • Common variable immunodeficiency
  • Hypogammaglobulinemia
  • Intravenous immunoglobulins
  • Sarcoidosis

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