Issue: 2008 > October > review

Low level IGF-1 and common variable immune deficiency: an unusual combination

K. van Bilsen, G.J. Driessen, R.A. de Paus, E. van de Vosse, K. van Lom, M.C. van Zelm, K.H. Lam, N.G. Hartwig, G.S. Baarsma, M. van de Burg, P.M. van Hagen


A relation between growth hormone (GH) deficiency and
immunoglobulin deficiency has been suggested previously in a few cases. We describe a patient with an insulin-like growth factor 1 (IGF-1) deficiency and common variable immune deficiency and briefly review earlier publications on the possible interaction between IGF-1 and the immune system.
IGF-1 is the downstream mediator of GH. In this patient,
GH and IGF-1 levels were both low. The GH response
to a GH-releasing hormone test was normal whereas no
subsequent IGF-1 response was seen. In our cohort of 14 patients with hypogammaglobulinaemia, two turned out to have slightly decreased IGF-1 serum levels and one patient with a thymoma had an increased IGF-1 level.
Even though IGF-1 may be connected to B lymphocyte
differentiation, in this patient we hypothesise there is a
common impairment in the IGF-1 and IgG pathways.