Yellow-nail-syndrome

Question

Hello,
my daughter has the Yellow-nail-syndrome.
Is there a connection between CF and the Yellow-nail-syndrome?
Many thanks!

Answer

Hello,
I answer your question with a "no", however I would like to add some comments here.

Up to now, according to my knowledge, there is no described case, in which a CF patient also developed a "Yellow-nail-syndrome" (YNS). Furthermore, there is no general connection concerning the development of the illness between both illnesses. Both illnesses develop independent of each other. However, the clinical picture of the CF as well as of the YNS comprise an involvement of the airways. In that a part of the YNS-patients show similar changes of the lung and similar clinical symptoms as CF-patients. These common findings however, have to be accused to the infections of the airways, which do in the end lead to similar changes of the lung caused by the illness. Thereby it is not fully clarified in YNS-patients how it comes to this.
In general functional or anatomical changes of the lymphatic flow are considered as reason for the illness at the YNS. These do possibly lead in the lung to a disturbed defence of bacteria, whereas here it seems to be the primitive immune defence mechanism which do not function anymore, as e.g. a disturbed drainage of bacteria from the airways. In that respect it is a similar mechanism in CF, which leads to chronic infections. However in CF the electrolyte exchange between the cells of the bronchial mucosa and the surface film of the airways is disturbed, which leads to drying of it and to a disturbed transport of bacteria, other germs and dust particles from the lung.

In case you follow another theory, namely that, that first bacterial infectons in the airways at the YNS cause the functional disturbances in the lymphatic vessels, than no more common findings between the illnesses can be found anymore except the picture of destruction of the lung which occurs in some YNS-patients. Of course it is imaginable that a patient suffers from both diseases, but such a case, as mentioned before, has not been described up to now. In case your question targeted at a common genetic connection, than this has to be negotiated according to the current knowledge.
Many greetings
O. Sommerburg

PD Dr. med. Olaf Sommerburg
Zentrum für Kinder- und Jugendmedizin, Kinderheilkunde III
Universitätsklinikum Heidelberg

25.06.2009