[Growth and chronic bronchopneumopathies]

The relationship between growth and pulmonary disease has been studied mainly in asthma and cystic fibrosis. In asthma, the most frequent chronic pulmonary disease in childhood, results were conflicting, until the degree of severity of the disease and growth phases were taken into account. Research on 683 children has shown that the percentage of underweight was higher in chronic than intermittent asthma. Moreover, the distribution of underweight patients by ages is different in the two types of asthma: uniform in intermittent asthma; two peaks below the age of 2 and above the age of 12 respectively in chronic asthma. Further data of 65 children treated with slow-releasing theophylline for approximately two years corroborates that puberty is a particularly vulnerable period. Indeed, in the most severe asthmatic males, theophylline is able to completely normalize the growth pattern in childhood but not in puberty. In cystic fibrosis malabsorption makes the study of the relationship between growth and pulmonary disease more complex. The pattern of growth in patients with cystic fibrosis is moving away from the normal pattern with ageing, hence the worsening of pulmonary disease is responsible for the worsening in the growth pattern. The growth pattern today is far better than that of 20 years ago. However, puberty, especially in female patients, is a critical period. Often the puberal spurt is delayed for a few years or is even completely absent. In a group of patients with chronic pulmonary disease due to different causes, weight is more implicated than height and the same pattern was observed in cystic fibrosis. Moreover, as in asthma, weight and height are more implicated in females than males. The entity of alteration observed is midway between the minimal in asthma and the maximal in cystic fibrosis.