Natural history of childhood asthma. 20-year follow-up

Abstract

Of 417 asthmatic children seen in hospital from 1941 to 1947, only 208 (50 %) were still attending the hospital and were available for long-term follow-up, whereas a 91 % follow-up was achieved from a personal follow-up of 267 asthmatic children seen in an East London group practice from 1948 to 1952 and followed for more than 20 years to December 1972. 125 patients (52%) were almost or completely symptom free; 51 (21 %) had never had any symptom-free period for longer than 6 months; a further 63 (27%) had a remission of symptoms for 3 years before relapsing. 7 patients died, 3 due to their asthma. The final prognosis was influenced by the severity of the asthma at onset, by breast feeding, by the presence of associated atopic disease, and by a positive family history of atopic disease in firstdegree relatives. It was uninfluenced by the age of onset of the asthma, by the sex of the patients, or by skin testing results. Short-term follow-up of such patients will fail to include those patients whose asthma remits and subsequently relapses.