29 years unrevealed illness of CF?

Question

Dear ladies and gentlemen,
I am female, 29 years old and suffer since birth from recurrent pulmonal diseases. Bronchitis, pneumonias, pleuritis...
When I was 11 years old the left lower lobe of the lung has been resected and then I did relatively well. In spite of the operation I still have about 80% FEV1.
However, since 2006 I have a worsening. Since then I get constantly other things, too. Fructose-intolerance (not inherited but acquired), chronic gastritis, chronic inflammation of the saliva glands, pain of the pleura, sickness and abdominal pain (which comes probably from the gastritis, as the enzymes of the pancreas are o.k.), under-weight (which has not been there before)...and the permanent infections of the lung (every 2-4 weeks fever).
A genetic test has been performed comprising 92% of the CF-allels present in the german population, with the result that no mutation has been found.
But somehow my mysterious symptoms puzzle me and I would like a sweat test having done for sure.
Would this be advisable?

Thank you very much,

Answer

Dear questioner,
in order to exclude CF, the performance of a sweat test makes sense besides the already done genetic analysis. The sweat test is namely the gold-standard, even in the time of genetic diagnostics in order to assure the diagnosis of CF. The result of the sweat test and the available CFTR-genetic analysis result should be correlated with your clinical picture and be judged in synopsis of all results, at best this should be done by an experienced CF-physician. In case the result of the sweat test should be negative, it has to be judged clinically if in your case an advanced, more specialized diagnostic in direction of CF is still required.
Yours sincerely,
Yours Dr. Christina Smaczny

10.01.2011