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

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 first-degree 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.