Clinical and laboratory features of geriatric patients with suspected immunodeficiency

Vollständiger Abstract

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Aims: The increasing life expectancy of the global population has led to a growing number of older adults presenting with recurrent infections and suspected immune dysfunction. However, immunodeficiencies remain underrecognized in the geriatric population because clinical manifestations often overlap with age-related immune changes and multiple comorbidities. This study aimed to evaluate the clinical, laboratory, and immunological characteristics of elderly patients referred for suspected immunodeficiency and to increase awareness of antibody deficiencies in this age group. Methods: This retrospective single-center study included patients aged ≥65 years who were referred to the allergy and immunology outpatient clinic with suspected immunodeficiency between January 2024 and December 2025. Patients with secondary immunodeficiency were excluded. Demographic characteristics, comorbidities, presenting symptoms, immunological findings, lymphocyte subset analyses, and serum immunoglobulin levels were extracted from medical records and analyzed. Results: Thirty patients were included, with a mean age of 70.5±5.1 years; 21 (70%) were female. At least one comorbidity was present in 24 patients (80%), most commonly hypertension (36.7%), hypothyroidism (33.3%), and diabetes mellitus (23.3%). Frequent upper respiratory tract infections were the leading reason for referral (53.3%), followed by bronchiectasis (13.3%) and recurrent pneumonia (10.0%). Immunological abnormalities were identified in 20 patients (66.7%). The most common finding was low serum IgM levels (26.7%), followed by common variable immunodeficiency (CVID) (16.7%), low IgA (10.0%), low IgG (10.0%), and IgG subclass deficiency (3.3%). Ten patients (33.3%) demonstrated normal immunological evaluations. No significant differences in immunological abnormalities were observed according to gender, age subgroup, or comorbidity status. Conclusion: Clinically relevant antibody deficiencies may be identified in geriatric patients referred for suspected immunodeficiency, highlighting the importance of appropriate immunological evaluation in selected elderly patients. Low IgM levels and CVID were the most common abnormalities. Recurrent infections in older adults warrant structured immunological evaluation to ensure timely diagnosis and management of immune disorders.