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Unexpected Death in Childhood AsthmaA Review of 13 Deaths in Ambulatory Patients
Lillian P. Kravis, MD;
Gerald B. Kolski, MD, PhD
Am J Dis Child. 1985;139(6):558-563.
Abstract
• Between January 1969 and January 1984, there were 13 deaths in ambulatory chronic asthmatics aged 9 to 19 years who had been followed up by physicians of the Allergy Section, Children's Hospital of Philadelphia. During this period, 5,686 children had been admitted to this institution for treatment of acute asthma and all had survived. Three possible causes for these deaths are suggested from a detailed review of each case. One cause may be medication-related, as exemplified by patient abuse of inhaled adrenergic drugs with concomitant erratic use of theophylline and corticosteroid drugs, or by physician failure to appreciate the need for corticosteroids. Serious behavioral disturbances account for some cases of medication misuse. A second cause of death may be an unsuspected pulmonary pathologic lesion, as revealed at autopsy, and a third cause may be sudden, intense airway narrowing, as has been reported in near deaths in hospitalized asthmatics.
(AJDC 1985;139:558-563)
Author Affiliations
From the Allergy/Immunology/Pulmonary/Bone-Marrow Transplantation Division, Department of Pediatrics, University of Pennsylvania Medical School, Children's Hospital of Philadelphia.
Footnotes
Reprint requests to Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104 (Dr Kravis).
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