The Excretion of 17-Ketosteroids and Gonadotrophin in Children: Normal and Abnormal Cases

Normal development in childhood, and the sex differentiation in growth which is a feature of this development, is essentially a matter of the activity of the anterior pituitary gland and the ability of the peripheral endocrine organs to respond to its stimulation. Developmental anomalies in child-hood, as in adult life, may be due to abnormalities either of pituitary secretion or of the gonads, adrenals, or other endocrine glands. The techniques which are available for the study of sex anomalies in the adult are applicable to an investigation of the sex mechanism of childhood, but relatively little work has been done in this field and it tends to be of a conflicting nature. Nathanson et al. (1941) have carried out a fairly elaborate investigation of the secretion of oestrogen and 17-ketosteroids in a group of normal girls and boys, and have been able to detect small, though fairly constant, amounts of both ho,rmones in children between three and seven years of age. At about seven years the excretion of 17-ketosteroids, which up to then had ranged from 1 5 to 4-5 mg. in twenty-four hburs, rose in both sexes to between 3 and 7 mg. a day. Boys from nine to eleven years tended to increase in androgen output more rapidly than girls, whose oestrogens increased more rapidly than in boys. Hormone output was correlated with physical development rather than with chronological age. Cycles in oestrogen excretion became obvious in girls at about the age of ten or eleven, and the rate of excretion greatly increased after eleven up to the menarche. This finding confirmed that of Frank (1935). That there is considerable divergence in the figures reported for androgen excretion in children is shown in table 1. Owing to the difficulty of comparing the biological unit with the colori-metric, data expressed in the former have not been given. * This investigation was carried out during the tenure of the Kirk