Late onset combined immunodeficiency (LOCID) is a recently described variant of common variable immunodeficiency (CVID), involving adult patients presenting with opportunistic infections and/or low CD4+ lymphocyte counts. We present a case of a 38-year, male, unmar-ried, who presented with history of abdominal pain and distension, jaundice and altered sleep- wake cycle suggestive of Decompensated liver disease. Patient developed multiple opportunistic infections in ward course which on further work up turned out to be Late onset combined immunodeficiency. Clinicians should be aware of LOCID, which could be confused with HIV infection/AIDS or idiopathic CD4 lymphocytopenia.
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