Necessity of sweat test

Question

A 3-year-old girl, who grew up normally, was diagnosed with enterocolitis at 8 months of age. Everything was normal in the past year. At the age of 2 years she had interstitial pneumonia, cured immediately with antibiotics; after almost a year since that episode the pneumonia appeared again, but this time with an abnormal X-ray. The diagnosis this time was post-viral right pneumonia, cured also with antibiotics. She had two episodes of acute bronchiolitis, which were cured without antibiotics but only by nebulised treatment. the doctors who saw her, told me that she doesn’t have a profile for cystic fibrosis, but a pulmonary physician reminded me about this disease. Please tell me if you think if it requires a sweat test? She has 94 cm and 12 kg at the age of 3 years, no diarrhea or steatorrhea, no coughing besides those periods of illness. Thank you!

Answer

Hello,
From what you report on your girl's evolution, she seems to have some respiratory problems, very common in any child. Typical forms of cystic fibrosis include, besides pulmonary manifestations and chronic diarrhea (absent in the case of your daughter), failure of growth (which does not seem to be) and other signs. Of course there are atypical forms of cystic fibrosis, but they are rare. Cystic fibrosis is a disease considered as differential diagnosis of chronic lung disease.
If doctors exclude common causes of pulmonary pathology such as recurrent wheezing, asthma etc. it is advisable to make a sweat test in a specialized center. Perhaps your child's doctor has more data, including biological investigations which can help establishing the diagnosis. Shortly, the sweat test is included in the diagnosis protocol of chronic lung diseases of children and is recommended by the physician.
Hoping that answer was useful, we wish you good health.

Best regards,
Dr. Ioana Mihaiela Ciucă

28.07.2014