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Growth in Asthmatic Children

  • Kostas N. Priftis
  • Michael B. Anthracopoulos
  • Anastasios Papadimitriou
Chapter

Abstract

Chronic illness per se, including asthma, may cause retardation of linear growth and this confounding factor is often difficult to separate from the potential stunting effect of inhaled corticosteroids (ICS) on children’s height. It has been proposed that the vast majority of asthmatic children will attain a normal adult height, and that most perceived growth failure is due to pubertal delay. Long-term treatment with ICS has profound effects on bone metabolism and linear growth. These effects are sensitive and specific and may represent an evolutionary adaptation in order to redirect resources during physiologic stress. It appears that any impairment of linear growth velocity in these children is likely to be reversible and of short duration. Although the deceleration of linear growth is widely accepted as a marker of the systemic effects of ICS, recent observational studies have reported that satisfactory growth does not exclude the possibility of adrenal suppression. Various polymorphisms in the glucocorticoid receptor could be related to the susceptibility to glucocorticoid-induced side effects. This chapter presents cutting-edge information of the effects of asthma per se as well as of ICS on linear growth of children and highlights the current knowledge on the interactions between this effect and that on the hypothalamic-pituitary-adrenal axis.

Keywords

Linear Growth Growth Velocity Asthmatic Child Final Height Adrenal Function 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

BDP

Beclomethasone dipropionate

BUD

Budesonide

FP

Fluticasone propionate

GCs

Glucocorticoids

GR

Glucocorticoid receptor

HPA

Hypothalamic-pituitary-adrenal

HSDS

Height standard deviation score

HVSDS

Height velocity standard deviation score

ICS

Inhaled corticosteroids

LDST

Low-dose stress test

SD

Standard deviation

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Kostas N. Priftis
    • 1
    • 4
  • Michael B. Anthracopoulos
    • 2
  • Anastasios Papadimitriou
    • 3
  1. 1.Department of Allergy-PulmonologyPenteli Children’s HospitalP. PenteliGreece
  2. 2.Third Department of PaediatricsUniversity of Athens School of Medicine, Attikon University HospitalAthensGreece
  3. 3.Respiratory Unit, Department of PaediatricsUniversity of PatrasPatraGreece
  4. 4.Third Department of PaediatricsUniversity of Athens School of Medicine, Attikon University HospitalAthensGreece

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