[Atopic skeletal retardation as a possible cause for short stature and thoracic deformity in children with asthma]. / Die atopische Skelettretardierung als eine mögliche Ursache für Kleinwuchs und Brustkorbdeformierung asthmakranker Kinder.

Deformities of the chest occur not only in asthmatics suffering from severe attacks, but also in those having a mild form of the disease. It also occurs in children with atopic dermatitis and in members of atopic families without concomitant bronchial asthma. This observation and the fact that asthmatic children tend towards hyposomia, has prompted auxological investigations of asthmatic children. It was of interest to see whether asthma itself or the atopic disposition is responsible for disturbances of growth and development. The investigation was carried out as a cross-sectional study involving 173 asthmatic boys aged 1 1/2-18 years. The programme included among other things age, bone age, bone maturity difference (BMD: difference age minus bone age) height, type and severity of asthma (measured by means of scope of therapy). The rate of hyposomia (height < mean -2 SD) amounted in the whole group to 4.7 per cent. It rose in the extrinsic asthmatics to 6.6 per cent. This corresponds with a rise of two or three times the normal rate. 11.6 per cent of the probands showed a skeletal retardation of more than 2 years. The degree of BMD showed a significant dependence on age and type of asthma but not on the duration of the disease, severity or glucocorticoid therapy. Skeletal retardation cannot, therefore, be regarded as a direct consequence of bronchial asthma, whereas the significantly different averages of BMD in extrinsic and intrinsic asthmatics point to an atopic genesis, hence it might be possible to speak of an atopic retardation of the skeleton.(ABSTRACT TRUNCATED AT 250 WORDS)

[Immunologic disorders in children with developmental thoracic defects]. / Immunologicheskie narusheniia u detei s defektami razvitiia grudnoi kletki.

As the result of immunological examination of 21 children with developmental defects of the chest and analysis of the course of the postoperative period in 136 children, among which 36 had hereditary syndromes of systemic connective-tissue dyshistogenesis, it was found that suppurative complications of thoracoplasty, which are encountered in 15% of children with isolated developmental chest defects and in 33.3% of those with the above mentioned syndromes, were caused to a great measure by disorders of the immune status. The most serious immunological deviations were encountered in the Marfan syndrome due to impaired phagocytic activity of neutrophils and monocytes, decreased number of T, T active, and B lymphocytes, and diminished function of T helpers. In unclassified complexes of developmental defects with Marfaneic ++ phenotypes, the immunological disorders were similar, but less deep. In the Ehlers-Danlos syndrome, a decrease of the number of immunocompetent cells, function of T helpers, and neutrophils was mainly revealed. In isolated forms of funnel chest the function of monocytes and the number of immunoglobulins are mainly decreased.