[Atopic skeletal retardation as a possible cause for short stature and thoracic deformity in children with asthma]

Deformities of the chest occur not only in asthmatics suffering from severe attacks, but also in those having a mild form of the disease. It also occurs in children with atopic dermatitis and in members of atopic families without concomitant bronchial asthma. This observation and the fact that asthmatic children tend towards hyposomia, has prompted auxological investigations of asthmatic children. It was of interest to see whether asthma itself or the atopic disposition is responsible for disturbances of growth and development. The investigation was carried out as a cross-sectional study involving 173 asthmatic boys aged 1 1/2-18 years. The programme included among other things age, bone age, bone maturity difference (BMD: difference age minus bone age) height, type and severity of asthma (measured by means of scope of therapy). The rate of hyposomia (height < mean -2 SD) amounted in the whole group to 4.7 per cent. It rose in the extrinsic asthmatics to 6.6 per cent. This corresponds with a rise of two or three times the normal rate. 11.6 per cent of the probands showed a skeletal retardation of more than 2 years. The degree of BMD showed a significant dependence on age and type of asthma but not on the duration of the disease, severity or glucocorticoid therapy. Skeletal retardation cannot, therefore, be regarded as a direct consequence of bronchial asthma, whereas the significantly different averages of BMD in extrinsic and intrinsic asthmatics point to an atopic genesis, hence it might be possible to speak of an atopic retardation of the skeleton.(ABSTRACT TRUNCATED AT 250 WORDS)