Death from asthma in children.

We have recorded 29 cases of death from asthma in children who had visited the Department of Pediatrics of Doai Memorial Hospital between 1965 and 1987. These cases have been analyzed. They were 18 males and 11 females. The mean age at death was 12.4 years and we found that in later childhood and adolescence the age at death had been increasing since 1973. The duration from final attack to death was very short: less than 1 hour: 21% and less than 2 hours: 50%. About half of the cases could not reach the hospital. Ten cases died within one year after cessation of long-term systemic use of steroid. Severe attacks of asthma were particularly likely to occur during the reducing period or following cessation of these drugs. The importance of adequate and vigorous initial therapy in severe asthmatic attacks should be emphasized. The causes of death are as follows: asphyxia: 23 cases (one complicated by aspiration, one withdrawal syndrome of steroid, one subendocardial haemorrhage and two pneumothorax cases), anaphylactic shock to ACTH: 1 case, shock to stimulant: 1 case, following emergency operation: 1 case and unknown: 3 cases. Asthma death in children in Japan is reviewed.