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Abstract：
OBJECTIVE: The aim of this study was to determine the clinical and immunological characteristics of older adults with common variable immunodeficiency (CVID).
METHODS: 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).
RESULTS: 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).
CONCLUSIONS: 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.
METHODS: 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).
RESULTS: 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).
CONCLUSIONS: 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.
摘要：
目的：这项研究的目的是确定患有普通可变免疫缺陷（CVID）的老年人的临床和免疫学特征。
方法：在2015年至2020年间随访诊断为CVID的年龄≥18岁的患者被纳入研究。根据诊断时的年龄将患者分为两个年龄组：成年组，年龄在18-65岁（n=49）和老年人组，年龄≥65岁（n=11）。
结果：脾肿大（55.1％vs.9.1%，p=0.006),支气管扩张(53.0%vs.9.1%，p=0.008),和自身免疫(42.8%vs.9.1%，p=0.036）被确定为在成人组中比在老年人中更常见。两组患者的恶性肿瘤发生率相似(6.1%vs.9.1%，p=0.721）。老年组没有合并症的患者明显多于成人组（45.5%vs.16.3%,p=0.034)。血清IgG和IgA水平在老年组显著高于成人组(全部p=0.001)。确定诊断时的CD19B细胞计数较低，老年人的CD19CD27IgD转换记忆B细胞和CD16CD56自然杀伤细胞计数高于成人组（分别为p=0.016，p=0.032，p=0.044）。
结论：了解老年CVID患者的临床和免疫学差异可能有利于多临床随访和治疗计划的改变。
方法：在2015年至2020年间随访诊断为CVID的年龄≥18岁的患者被纳入研究。根据诊断时的年龄将患者分为两个年龄组：成年组，年龄在18-65岁（n=49）和老年人组，年龄≥65岁（n=11）。
结果：脾肿大（55.1％vs.9.1%，p=0.006),支气管扩张(53.0%vs.9.1%，p=0.008),和自身免疫(42.8%vs.9.1%，p=0.036）被确定为在成人组中比在老年人中更常见。两组患者的恶性肿瘤发生率相似(6.1%vs.9.1%，p=0.721）。老年组没有合并症的患者明显多于成人组（45.5%vs.16.3%,p=0.034)。血清IgG和IgA水平在老年组显著高于成人组(全部p=0.001)。确定诊断时的CD19B细胞计数较低，老年人的CD19CD27IgD转换记忆B细胞和CD16CD56自然杀伤细胞计数高于成人组（分别为p=0.016，p=0.032，p=0.044）。
结论：了解老年CVID患者的临床和免疫学差异可能有利于多临床随访和治疗计划的改变。
