Studies on disorders of growth in childhood with particular reference to the anterior pituitary gland

Abstract

Forty-one boys and twenty -nine girls were studied and sixty - seven of these children were investigated because of their small size. Attention was paid. to the following points in the history and clinical examination; chief complaint, birth weight, birth order, pregnancy and confinement, maternal age at birth, parental heights, height and skeletal age, and the age at which "small size" was noticed.

Tests of anterior pituitary function were applied and these were based upon the response of target organs. Eighteen children were found to have a primary disease process initially unrelated to the anterior pituitary, and certain of these were discussed, e.g. chronic regional ileitis, and erythrogenesis imperfecta with transfusion haemosiderosis. The association of anaemia with hypopituitarism in two girls was considered, and twelve children with a history of convulsions were examined in detail.

Thirty-seven children were investigated using all the tests of endocrine function available in this study. They showed no clinical evidence of a destructive pituitary lesion and they were grouped according to their biochemical findings. No conclusive evidence was obtained on comparison of these groups with certain physical attributes, e.g. birth weight and parental height. A classification of endocrine disorders of growth in pre -pubertal children based upon biochemical defects was proposed for research purposes.

Metabolic studies with Human Growth Hormone were carried out in four children and they showed variable responses but no evidence of hypercalciuria which has been described by others. Attempts to establish Read's method of assay of Human Growth Hormone were unsuccessful.