Linear growth of chronic asthmatic children: the effects of the disease and various forms of steroid therapy

Chang, Kuo-Song; Miklich, Donald R.; Barwise, G.; Chai, Hyman; Miles-Lawrence, R.

doi:10.1111/j.1365-2222.1982.tb02541.x

Cited by 47 publications

(18 citation statements)

References 25 publications

(21 reference statements)

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“…Details are given in Table 1. However, the proportion of 25.0% reported by Chang et al (1982) refers to children suffering from severe chronic asthma. The rate of short stature in patients treated at our centre was shown to be 4.7% for boys and 8.2% for girls (Baum et al, 1993 b).…”

Section: Prevalence Of Growth and Development Disturbance In Cases Ofmentioning

confidence: 91%

Delay of growth and development in children with bronchial asthma, atopic dermatitis and allergic rhinitis

Baum¹,

Schneyer²,

Lantzsch³

et al. 2002

Exp Clin Endocrinol Diabetes

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The elevated incidence of short stature (body height < (-)x - 2s), skeletal retardation and delayed puberty in children with bronchial asthma or atopic dermatitis is generally attributed to the severity of the disorder. However, a series of findings indicate a causal influence of the atopy and the existence of atopic skeletal retardation per se.The observation that children with atopic disorders, whether bronchial asthma, atopic dermatitis or allergic rhinitis, exhibit a rate of short stature that is twice to five times higher than normal indicates atopic and thus genetically determined influences. The elevated prevalence of short stature associated with allergic rhinitis is especially significant, as this disorder cannot be included among the severe chronic disorders. The fact that skeletal retardation is more prevalent in boys than in girls by a ratio of about 2:1 and that a significantly more marked retardation of bone maturation is found in atopic in comparisons with non-atopic asthmatics also lend support to this postulation. The clinical relevance of atopic growth retardation is also supported by the close interaction of pathophysiological basal mechanisms of bone metabolism and the atopy status. Thus the local growth factor prostaglandin E(2) (PGE(2)), which is important for bone metabolism, is also a messenger substance for the immediate and late allergic reaction. The platelet-activating factor (PAF), as one of the strongest mediators in the pathogenesis of allergic disorders, influences the PGE(2) synthesis in the osteoblasts. These relationships show that atopy-dependent imbalances in the complex system of local and systemic growth factors can certainly lead to disturbance of skeletal maturation which may delay growth and development in atopic children. In order to verify these assumptions it is necessary to research the interaction of local growth factors (particularly the roles of PGE(2), PAF and IGF I) in the skeletons of children of short stature suffering from atopic disorders. This should also include the possible effects on the overall hormonal factors influencing bone maturation. Atopy should be included in the differential diagnosis programme to clarify growth and development disturbances.

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Section: Prevalence Of Growth and Development Disturbance In Cases Ofmentioning

confidence: 91%

Delay of growth and development in children with bronchial asthma, atopic dermatitis and allergic rhinitis

Baum¹,

Schneyer²,

Lantzsch³

et al. 2002

Exp Clin Endocrinol Diabetes

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“…In Brazil, Kovalhuk et al (59) did not observe growth retardation either, during the study period, in patients on prednisone given on alternate days or BDP. On the other hand, growth retardation associated with the use of inhaled corticosteroids was documented by other authors (75)(76)(77)(78)(79)(80)(81)(82)(83)(84)(85)(86) . So, there is evidence that inhaled corticosteroids can reduce growth speed, mainly when given in high doses.…”

Section: Inhaled Corticosteroids and Growthmentioning

confidence: 99%

Linear growth in asthmatic children

et al. 2003

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Asthma is the most frequent chronic inflammatory disease in childhood, and its prevalence has increased remarkably over the last decades. Therefore, the scientific community became interested in studying the growth of the affected children. The relationship between asthma and growth suffers the influence of the clinical picture, of therapeutics, but the different study methods make it difficult to distinguish the factors responsible for the growth retardation detected by some authors. This review has the purpose of providing an overall outlook on this matter. (J Pneumol 2003;29(1):36-42)

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“…However, this difference in height was only seen at age 14 years, and no difference was apparent by 21 years, indicating that the main effect of oral corticosteroids was to cause growth delay and affect the timing of puberty. The degree of growth retardation has been clearly linked to the frequency of oral corticosteroid use 3. However, there is also evidence that adult height can be permanently reduced in some children who have received long term oral corticosteroids for asthma 4…”

Section: Oral Corticosteroidsmentioning

confidence: 99%