Croup?

Question

Hello,

my 6-year-old son has been having coughs (infections) since age 1 and has to throw up mucus. The doctors said that he has croup. It is getting worse each year. Last year he had a budding pneumonia and empty-stomach vomiting, abdominal pain, and strange stool (brown-white-yellowish with yellow mucous).

An MRI showed chronic polypoid pansinusitis. A suspicion of CF was raised. A sweat test we had done yesterday returned a normal value, though. My son is sweating very, very heavily, could this affect the test value? It is worst on his head, and the sweat is very salty there, but only there.

Please send me an answer, none of the doctors can tell us what he has.

Thanks.

Answer

Hello,

you report that your 6-year-old son has been suffering from croup, that his troubles have been increasing lately, and that he almost had pneumonia. An MRI showed pansinusitis and a suspicion of CF was raised. A recent sweat test was normal.

In addition, you son has been having abdominal pain, empty-stomach vomiting in the mornings, and the stool is changed, partly with yellow mucous.

Concerning the ailments you mention, it has to be said that these symptoms can sometimes worsen in children who have a tendency to croup and that even pneumonia can occur occasionally.

The fact that the MRI showed parasinusitis is making me pause, of course. Such parasinusitis usually occurs in patients with intense allergies and in CF. It is know that some of the children who suffer from croup as an infant develop allergic asthma or hay fever later, for instance. Such parasinusitis usually only develops during adulthood, however.

To be completely sure about the CF suspicion, I would like to suggest for you to have the sweat test repeated. By all means, this should be done as a repeat determination on both arms at a qualified CF center.

Your son’s ailments of the digestive tract should also be checked on further. The abdominal pain and particularly the vomiting on an empty stomach in the mornings could point to a reflux disorder. Furthermore, given the abnormal stool, you should rule out food allergies or intolerances (e.g. celiac disease) and pancreatic hypofunction.

Younger children often sweat particularly strong on the head without necessarily being sick. This phenomenon can also be observed in times of health strain.

Kind regards
Dr. H.-G. Posselt

07.09.2010