Thyroid function in children with growth hormone deficiency,either idiopathic or caused by diseases of the central nervous system

Thyroid function was assessed in thirty two patients with growth hormone deficiency (GHD) by clinical examination and by measurement of T₄-levels, free T₄-indices, basal TSH values and TSH responses to TRH (100 g/m²). Sixteen patients (50%) were hypothyroid. In thirteen patients, the endocrine disorders were considered to be of hypothalamic origin. Ten of them showed prolonged responses to TRH and in the other three the responses were exaggerated. In three patients hypothyroidism was due to a primary pituitary disorder. Sixteen patients were euthyroid although three of them showed impaired TSH responses. In the cases with idiopathic hypopituitarism (n=20) there was a high incidence of abnormal births in the children with additional hypothalamic hypothyroidism, but not in the euthyroid patients. It is concluded that in patients with previous breech or vacuum extraction delivery, growth hormone deficiency when combined with hypothalamic hypothyroidism may be due to birth trauma.