Cystic Fibrosis?

Question

Hello,

information that I found in the internet has made me think that I might have a mild form of CF.

My personal data:
28 years old, female
Since childhood recurring infections like sinusitis, bronchitis, pneumoniae & Otitis media. Once I had a myocarditis with a short stay at the hospital.During infancy I was diagnosed with allergic Asthma bronchiale and exercise-induced asthma and I have to take medication regularly for this reason. I have never tolerated fatty food well, it caused diarrhea and gall problems (rising bile). At age 11, tonsillectomy (TE) operation where also polyps where removed since I had chronic anginas with very enlarged tonsils. Since I was about 16 I was underweight, now my BMI is normal. I have never experienced to feel completely well and according to my mother I have been ill permanently. Personally, I think, this is not such a big problem but I am just not as high-capacity as other women of my age. Especially, I am having problems with being tired and exhausted all the time. Currently I just had a lateral pharyngitis with starting bronchitis and strong sinusitis which was treated with antibiotics. Only the second antibiotic had an effect after 1,5 weeks. I sweat very much since I remember and during infections I do sweat in such an extreme manner that I have to change the bedclothes in the morning.
Fresh sweat tastes very salty. I drink three litre daily (minimum) and eat pretty salty since I have the feeling that I need it. Due to the current sinusitis my general practicioner referred me to the ENT-specialist after 2 weeks. He seemed concerned when he heard that I was operated three times for this reason (2 times widening of the paranasal sinuses & operation of the nasal septum). He said that there has to be a reason that I am still having a chronic sinusitis despite the operations and the medication. He wants to have a CT done once the swelling has gone down and then decide if another operation would be necessary.
Reading up on chronic sinusitis, I now found that unsuccessful treatment can be a sign of CF. Now I am seriously worried, since my second cousin was diagnosed with CF only as an adult and died of it before turning 30.
On the one hand, I do not want to come across as a hypochondriac; as it is, I hardly go to the doctor and try to do a lot with alternative medicine, but there are limits to that, after all…
Now my question: Do you as an expert team think that the symptoms I am describing could point to CF, or am I being too subjective? Is a sweat test sensible in your opinion, or is that taking it too far?
Many thanks in advance for your effort, time and answer!

Kind regards.

PS: Apologies for the lengthy message!

Answer

Dear questioner,

Your descriptions show us that you are very worried about your health due to your troubles and the CF case in your family. For that reason alone, I consider a sweat test justified. Your problems could well occur in CF as well, but they are in no case proof of the disease; therefore it makes great sense to clarify things in order to ease your worries.
The sweat test is only a very minor burden on you, and the treatment costs for your insurance company are justifiable to clarify your problem. The sweat test is still the gold standard to secure a diagnosis in CF, and your general practitioner can refer you to a CF centre for this test. You should just pay attention that the test is being done in a certified CF centre so that the procedure is carried out according to the recognized standards and the result will be discussed with you.
Your local/national patient association should be able to provide you with addresses of certified centres. [Translator’s note: information pertaining only to Germany was omitted in the translation.] Make sure to ask specifically whether the respective centre offers sweat test diagnostics, though.

Kind regards
Dr. Christina Smaczny.

11.09.2012