Diagnostic and aetiologic features of idiopathic and symptomatic growth hormone deficiency in the Netherlands. A survey of 176 children.

In a survey of 176 children with hypopituitary growth failure symptomatic growth hormone deficiency (organic disease) was found in 25, whereas 151 children had idiopathic growth hormone deficiency. An isolated deficiency of growth hormone (IGHD) was found in 69 children of the latter group, 82 children had multiple pituitary hormone deficiency (MPHD). The sex ratio (boys/girls) in all idiopathic cases was 2.4. Familial occurrence was encountered in four families. This disorder did not occur more often in firstborn than in later-born children. Breech delivery was found in 37.1% of all idiopathic cases; it occurred more frequently in MPHD than in IGHD and in boys than in girls. 14% of 143 children with idiopathic growth hormone deficiency had a birthweight of 2500 g or less, which is more than the incidence in the country. The mean birthweight of children born at a gestational age of 38 weeks or more was normal. In view of the high incidence of breech delivery (presumably with associated birth injury) and the high familial occurrence, the aetiology in the majority of cases would be adequately described by a multifactioral mode of inheritance.