Clinical and laboratory features of geriatric patients with suspected immunodeficiency

Fikriye Kalkan; Begüm Görgülü Akın; Makbule Seda Bayrak Durmaz; Betül Özdel Öztürk; Şadan Soyyiğit

Clinical and laboratory features of geriatric patients with suspected immunodeficiency

Abstract

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.

Keywords

Ethical Statement

Ethical consideration : Approval for the study was obtained from the Ankara Bilkent City Hospital (Approval No: TABED-2-26-2374), and the study was conducted in accordance with the principles of the Declaration of Helsinki.

References

Regina J, Doms J, Kampouri E, et al. Immunodeficiencies in adults: key considerations for diagnosis and management. Clin Rev Allergy Immunol. 2025;68(1):92. doi:10.1007/s12016-025-09103-9
Kindle G, Alligon M, Albert MH, et al. Inborn errors of immunity: manifestation, treatment, and outcome-an ESID registry 1994-2024 report on 30,628 patients. J Hum Immun. 2025;1(3):e20250007. doi:10.70962/jhi.20250007
Goyani P, Christodoulou R, Vassiliou E. Immunosenescence: aging and immune system decline. Vaccines (Basel). 2024;12(12):1314. doi:10.3390/vaccines12121314
Lee KA, Flores RR, Jang IH, Saathoff A, Robbins PD. Immune senescence, immunosenescence and aging. Front Aging. 2022;3:900028. doi:10.3389/fragi.2022.900028
Fetarayani D, Kahdina M, Waitupu A, et al. Immunosenescence and the geriatric giants: molecular insights into aging and healthspan. Med Sci (Basel). 2025;13(3):100. doi:10.3390/medsci13030100
Ventura MT, Scichilone N, Paganelli R, et al. Allergic diseases in the elderly: biological characteristics and main immunological and non-immunological mechanisms. Clin Mol Allergy. 2017;15:2. doi:10.1186/s12948-017-0059-2
Milgrom H, Huang H. Allergic disorders at a venerable age: a mini-review. Gerontology. 2014;60(2):99-107. doi:10.1159/000355307
Cunha LL, Valsecchi VAdS, Ward LS. Investigating population-level immunosenescence: from bench to bedside. Front Immunol. 2022;13: 949928. doi:10.3389/fimmu.2022.949928

Lang A, Grammatikos A, Ballow M, Otani I, Barmettler S. Risk factors for secondary immunodeficiency in the aged. J Allergy Clin Immunol Pract. 2026. doi:10.1016/j.jaip.2026.05.022
Palacios-Ortega M, Guerra-Galán T, Jiménez-Huete A, et al. Dissecting secondary immunodeficiency: identification of primary immunodeficiency within B-cell lymphoproliferative disorders. J Clin Immunol. 2024;45(1):32. doi:10.1007/s10875-024-01818-2
Seidel MG, Kindle G, Gathmann B, et al. The European Society for Immunodeficiencies (ESID) registry working definitions for the clinical diagnosis of inborn errors of immunity. J Allergy Clin Immunol Pract. 2019;7(6):1763-1770. doi:10.1016/j.jaip.2019.02.004
Kindle G, Alligon M, Albert MH, et al. Inborn errors of immunity: manifestation, treatment, and outcome-an ESID registry 1994-2024 report on 30,628 patients. J Hum Immun. 2025;1(3):e20250007. doi:10.70962/jhi.20250007
Khan SR, van der Burgh AC, Peeters RP, van Hagen PM, Dalm V, Chaker L. Determinants of serum immunoglobulin levels: a systematic review and meta-analysis. Front Immunol. 2021;12:664526. doi:10.3389/fimmu.2021.664526
Listi F, Candore G, Modica MA, et al. A study of serum immunoglobulin levels in elderly persons that provides new insights into B cell immunosenescence. Ann N Y Acad Sci. 2006;1089:487-495. doi:10.1196/annals.1386.013
Santoro A, Bientinesi E, Monti D. Immunosenescence and inflammaging in the aging process: age-related diseases or longevity? Ageing Res Rev. 2021;71:101422. doi:10.1016/j.arr.2021.101422
Agarwal S, Busse PJ. Innate and adaptive immunosenescence. Ann Allergy Asthma Immunol. 2010;104(3):183-210. doi:10.1016/j.anai.2009.11.009
Danieli MG, Mezzanotte C, Verga JU, et al. Common variable immunodeficiency in elderly patients: a long-term clinical experience. Biomedicines. 2022;10(3):635. doi:10.3390/biomedicines10030635
Quinti I, Soresina A, Spadaro G, et al. Long-term follow-up and outcome of a large cohort of patients with common variable immunodeficiency. J Clin Immunol. 2007;27(3):308-316. doi:10.1007/s10875-007-9075-1
Zietkiewicz M, Wiesik-Szewczyk E, Matyja-Bednarczyk A, Napiorkowska-Baran K, Zdrojewski Z, Jahnz-Rozyk K. Shorter diagnostic delay in Polish adult patients with common variable immunodeficiency and symptom onset after 1999. Front Immunol. 2020;11:982. doi:10.3389/fimmu.2020.00982
Westh L, Mogensen TH, Dalgaard LS, et al. Identification and characterization of a nationwide Danish adult common variable immunodeficiency cohort. Scand J Immunol. 2017;85(6):450-461. doi:10.1111/sji.12551
Odnoletkova I, Kindle G, Quinti I, et al. The burden of common variable immunodeficiency disorders: a retrospective analysis of the European Society for Immunodeficiency (ESID) registry data. Orphanet J Rare Dis. 2018;13(1):201. doi:10.1186/s13023-018-0941-0
Fortier JC, Haltigan E, Cavero-Chavez V, et al. Clinical and phenotypic characterization of common variable immunodeficiency diagnosed in younger and older adults. J Clin Immunol. 2022;42(6):1270-1279. doi:10.1007/s10875-022-01290-w
Yildiz E, Colkesen F, Evcen R, et al. The clinical and immunological characteristics of common variable immunodeficiency in adults and older adults. North Clin Istanb. 2024;11(3):201-207. doi:10.14744/nci.2023.49699

Details

Primary Language

English

Subjects

Allergy

Journal Section

Research Article

Authors

Fikriye Kalkan ^*
0000-0002-7199-436X
Türkiye

Begüm Görgülü Akın
0000-0002-6200-0909
Türkiye

Makbule Seda Bayrak Durmaz
0000-0001-8272-5686
Türkiye

Betül Özdel Öztürk
0000-0001-8653-3497
Türkiye

Şadan Soyyiğit
0000-0003-3270-5884
Türkiye

Publication Date

August 15, 2026

Submission Date

June 19, 2026

Acceptance Date

July 28, 2026

Published in Issue

Year 2026 Volume: 7 Number: 4

IZ

https://izlik.org/JA36KZ72UL

Cite

RIS / Bibtex

APA

Kalkan, F., Görgülü Akın, B., Bayrak Durmaz, M. S., Özdel Öztürk, B., & Soyyiğit, Ş. (2026). Clinical and laboratory features of geriatric patients with suspected immunodeficiency. Journal of Medicine and Palliative Care, 7(4), 813-818. https://izlik.org/JA36KZ72UL

AMA

1.Kalkan F, Görgülü Akın B, Bayrak Durmaz MS, Özdel Öztürk B, Soyyiğit Ş. Clinical and laboratory features of geriatric patients with suspected immunodeficiency. J Med Palliat Care / JOMPAC / jompac. 2026;7(4):813-818. https://izlik.org/JA36KZ72UL

Chicago

Kalkan, Fikriye, Begüm Görgülü Akın, Makbule Seda Bayrak Durmaz, Betül Özdel Öztürk, and Şadan Soyyiğit. 2026. “Clinical and Laboratory Features of Geriatric Patients With Suspected Immunodeficiency”. Journal of Medicine and Palliative Care 7 (4): 813-18. https://izlik.org/JA36KZ72UL.

EndNote

Kalkan F, Görgülü Akın B, Bayrak Durmaz MS, Özdel Öztürk B, Soyyiğit Ş (August 1, 2026) Clinical and laboratory features of geriatric patients with suspected immunodeficiency. Journal of Medicine and Palliative Care 7 4 813–818.

IEEE

[1]F. Kalkan, B. Görgülü Akın, M. S. Bayrak Durmaz, B. Özdel Öztürk, and Ş. Soyyiğit, “Clinical and laboratory features of geriatric patients with suspected immunodeficiency”, J Med Palliat Care / JOMPAC / jompac, vol. 7, no. 4, pp. 813–818, Aug. 2026, [Online]. Available: https://izlik.org/JA36KZ72UL

ISNAD

Kalkan, Fikriye - Görgülü Akın, Begüm - Bayrak Durmaz, Makbule Seda - Özdel Öztürk, Betül - Soyyiğit, Şadan. “Clinical and Laboratory Features of Geriatric Patients With Suspected Immunodeficiency”. Journal of Medicine and Palliative Care 7/4 (August 1, 2026): 813-818. https://izlik.org/JA36KZ72UL.

JAMA

1.Kalkan F, Görgülü Akın B, Bayrak Durmaz MS, Özdel Öztürk B, Soyyiğit Ş. Clinical and laboratory features of geriatric patients with suspected immunodeficiency. J Med Palliat Care / JOMPAC / jompac. 2026;7:813–818.

MLA

Kalkan, Fikriye, et al. “Clinical and Laboratory Features of Geriatric Patients With Suspected Immunodeficiency”. Journal of Medicine and Palliative Care, vol. 7, no. 4, Aug. 2026, pp. 813-8, https://izlik.org/JA36KZ72UL.

Vancouver

1.Fikriye Kalkan, Begüm Görgülü Akın, Makbule Seda Bayrak Durmaz, Betül Özdel Öztürk, Şadan Soyyiğit. Clinical and laboratory features of geriatric patients with suspected immunodeficiency. J Med Palliat Care / JOMPAC / jompac [Internet]. 2026 Aug. 1;7(4):813-8. Available from: https://izlik.org/JA36KZ72UL