Mellis C M, Phelan P D
Thorax. 1977 Feb;32(1):29-34. doi: 10.1136/thx.32.1.29.
The clinical and pathological features of five children who died of asthma over a recent 12-month period are reported. All had severe, chronic asthma requiring maintenance corticosteroid therapy. Three had been receiving beclomethasone dipropionate by inhalation and these had acute inflammation of the tracheobronchial tree at necropsy. Adrenal atrophy was found in all four cases examined histologically, despite normal short tetracosactrin tests in three of these shortly before they died. The need for high-dose corticosteroid by mouth for exacerbations of asthma in those weaned from oral steroids is emphasized by these deaths. The introduction of beclomethasone dipropionate by inhalation has led to an increase in the number of children in this high-risk group.
报告了近期12个月内死于哮喘的5名儿童的临床和病理特征。所有患儿均患有严重的慢性哮喘，需要长期使用皮质类固醇治疗。3名患儿通过吸入丙酸倍氯米松进行治疗，尸检时发现这些患儿的气管支气管树有急性炎症。在组织学检查的所有4例病例中均发现肾上腺萎缩，尽管其中3例在死亡前不久的短程促肾上腺皮质激素试验结果正常。这些死亡病例强调了对于那些已停用口服类固醇药物的患儿，在哮喘发作时需要口服大剂量皮质类固醇。吸入丙酸倍氯米松的使用导致了这一高危群体中儿童数量的增加。
