Yildiz Eray, Colkesen Fatih, Evcen Recep, Aykan Filiz Sadi, Kilinc Mehmet, Aytekin Gokhan, Arslan Sevket
Department of Clinical Immunology and Allergy, Necip Fazil City Hospital, Kahramanmaras, Turkiye.
Division of Clinical Immunology and Allergy, Department of Internal Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkiye.
North Clin Istanb. 2024 Jun 24;11(3):201-207. doi: 10.14744/nci.2023.49699. eCollection 2024.
The aim of this study was to determine the clinical and immunological characteristics of older adults with common variable immunodeficiency (CVID).
Patients aged ≥18 years who were followed up with the diagnosis of CVID between 2015 and 2020 were included in the study. The patients were separated into two age groups according to the age at diagnosis: the adult group, aged 18-65 years (n=49) and the older adult group, aged ≥65 years (n=11).
Splenomegaly (55.1% vs. 9.1%, p=0.006), bronchiectasis (53.0% vs. 9.1%, p=0.008), and autoimmunity (42.8% vs. 9.1%, p=0.036) were determined to be more common in the adult group than in the older adults. A similar frequency of malignancy was seen in both groups (6.1% vs. 9.1%, p=0.721). There were significantly more patients with no comorbidity in the older adult group than in the adult group (45.5% vs. 16.3%, p=0.034). Serum IgG and IgA levels were determined to be significantly higher in the older adult group than in the adult group (p=0.001 for all). The CD19+ B-cell count at the time of diagnosis was determined to be lower and the CD19+CD27+IgD- switched memory B-cells and CD16+CD56+ natural killer cell counts were higher in the older adults than in the adult group (p=0.016, p=0.032, p=0.044, respectively).
Knowledge of clinical and immunological differences in older adult CVID patients may be of benefit in polyclinic follow-up and in respect of changes to be made to the treatment plan.
本研究旨在确定普通变异型免疫缺陷（CVID）老年患者的临床和免疫学特征。
纳入2015年至2020年间诊断为CVID并接受随访的≥18岁患者。根据诊断时的年龄将患者分为两个年龄组：18 - 65岁的成年组（n = 49）和≥65岁的老年组（n = 11）。
发现脾肿大（55.1% 对 9.1%，p = 0.006）、支气管扩张（53.0% 对 9.1%，p = 0.008）和自身免疫（42.8% 对 9.1%，p = 0.036）在成年组中比老年组更常见。两组中恶性肿瘤的发生率相似（6.1% 对 9.1%，p = 0.721）。老年组中无合并症的患者明显多于成年组（45.5% 对 16.3%，p = 0.034）。老年组血清IgG和IgA水平明显高于成年组（均p = 0.001）。诊断时老年组的CD19 + B细胞计数较低，而CD19 + CD27 + IgD - 转换记忆B细胞和CD16 + CD56 + 自然杀伤细胞计数高于成年组（分别为p = 0.016、p = 0.032、p = 0.044）。
了解老年CVID患者的临床和免疫学差异可能有助于门诊随访以及制定治疗方案的调整。
