Asthmatic Deaths in Children

To the Editor:— The editorial on asthmatic death in children ( 193 : 678, 1965) seems very important to us, considering the apparently paradoxical increased death rate in asthmatic children during the last ten years. If we exclude from Richards' cases those who died under the age of 1 year (remembering the difficulty of clinical diagnosis of asthma in this age group), the increase of the mortality, particularly during the last few years, is even more impressive. Each of the explanations given has its merits, but it is our feeling that the most important factor contributing to this increased death rate is long-term steroid adminstration. The progressive hypoadrenalism caused by prolonged steroid therapy results finally in a failure of response to even a mild infection. In this way it leads to the unexpected sudden death.