Death From Asthma in Children

Abstract

MANY EXCELLENT REPORTS 1-22 have appeared concerning the pathology and mechanisms of death in acute asthma. However, there has been little specific reference to the pediatric age group. This paper is a review of deaths from asthma at the Childrens Hospital of Los Angeles between the years 1937 and 1963 in an attempt to elucidate possible mechanisms in children. Methods and Materials Asthma was defined as a form of obstructive emphysema involving both lungs throughout, manifested clinically by recurrent paroxysmal dyspnea and wheezing, chiefly expiratory, heard on auscultation of the chest and typically relieved, at least in the early stages of an attack, by sympathomimetic drugs. The pathologic criteria of death from acute asthma were autopsy findings of bronchial basement membrane thickening, bronchial muscular hypertrophy, inspissated mucous plugs, mucous gland metaplasia, and eosinophilic infiltrates in the bronchi. The hospital records of children who were thought to have died with asthma,