Cystic fibrosis

Question

Hello,

I have a 8-year-old daughter. She was diagnosed with a bronchial stenosis when she was a baby; an operation was done to take care of it.
Two weeks ago we went to the hospital in Munich and it was diagnosed that the lung artery pushes against the bronchus and that is the reason for the constriction. A computer tomography was done. For six weeks now she has problems with cough and fever. The paediatrician prescribed a sweat test. The first value was 55, the second was 59. Currently, she has a heavy bacterial infection, though, and therefore we are supposed to treat it for two weeks with antibiotics and then have a third test done. Can the infection have an influence on the value of the sweat test? Can we assume that the current values relate to mild CF?

Answer

Hello,

You are saying that your 8-year-old daughter was diagnosed with a bronchial stenosis when she was a baby and that an operation was done to take care of it. Furthermore, you are saying that two weeks ago it was diagnosed at the university hospital in Munich that a lung artery pushes against the bronchus and that this is the reason for the constriction. It can be assumed, though, that the first operation had not repaired the stenosis.

Since your daughter has had problems with a severe infection with cough and fever for six weeks now, a sweat test and then a control test was done. The chloride value measured was 55 and then 59 mmol/l.

You are asking if you can assume that the current values relate to mild CF and if the infection can have an influence on the values of the sweat tests?

With regard to the sweat test results it can be said that both values are close to each other. Therefore, it is unlikely that gross mistakes happened related to the determined values. It would be interesting to know if the sweat test was done in the CF department of the children’s hospital in Munich. If so, you are at the perfectly right place. Due to the extraordinary antecedent of your daughter it does make sense for sure to have the test done again. This is true especially if the test was not done at the University children’s hospital.

In general, for the time being, I would not speak of cystic fibrosis right now in case of your child.

The current values are in the treshold range and further verifying findings would be necessary to confirm a cystic fibrosis. You should discuss this with the experts at the CF center at the university children's hospital.
Concerning your other question if the infection has an influence on the sweat test results it can be said that only in extreme cases of dehydration under a febrile infection changes in the sweat test results would have to be expected. This does not seem to apply for our daughter.

I hope that your daughter is getting better soon and that a cystic fibrosis can be excluded by further testing.

Best regards,
Dr. H.-G. Posselt

14.05.2012