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Growth and Skeletal Maturation in Asthmatic Children: Effect of Corticosteroid Treatment

Extract: The effects of corticosteroid treatment on growth and skeletal maturation were evaluated in 189 children with severe asthma who were referred for care at a residential treatment center. Height age on admission was significantly retarded in 8–10% of patients who had received little corticosteroid treatment previously and in 35% of patients who had taken steroids daily for more than 2 years. Children who had been treated with steroids intermittently or on alternate days were comparable to those who had taken steroids rarely. During an average residential period of 17 months, patients whose daily steroid treatment was discontinued had a relative gain in height age of 5 months; children who were started on daily steroids had a 5-month delay in growth. Evaluation of skeletal maturation at the time of admission revealed that skeletal age was more retarded than height age in the boys and less retarded than height age in the girls. During the period of residence, the changes in bone age paralleled the changes in height age.Speculation: Suppression of growth is a frequent complication in asthmatic children who receive prolonged treatment with corticosteroids. In some patients the suppression of growth may result in permanent dwarfism. However, no information is currently available on the adult heights of patients who have received prolonged corticosteroid therapy during childhood.