cf

Question

I have a 4 year and 9 months old daughter. She is coughing several times a day, especially in the first part of the day. She was diagnosed with asthma 2 years ago and does not respond well to the treatment. The sweat test and the value of the test was 55mmol/L and 57mmol/L.
Is it possible for her to have Cystic fibrosis?

Answer

Hello,
Consider what you are saying, in your daughter's case respiratory symptoms predominate. In case this symptoms persist, we recommended you to repeat the sweat test or undergo extensive CFTR mutation analysis (genetic test), expanded panel of CFTR mutations.
Concerning the sweat test it is important to have it done at an experienced center using the so-callled pilocarpine ionotophoresis to measure the chloride concentration in the sweat. If this the case, values over 60 mmol/l are regarded to be positive, those that are between 40-60 mmol/l are in the intermediate range and have also to be clarified further.
There are many cases of chronic cough in children and you must exclude all that, to put the right diagnosis.
CF is a polymorphic disease, with a different clinical expression, respiratory or digestive manifestation (chronic diarrhea with steatorrhea, recurrent pancreatitis, chronic liver disease, meconium ileus), failure to thrive. There are also atypical forms of the disease.
We recommend a reassessment of your child case, in particular because there are other things that can influence the sweat test result.
Please write us if you have other question.
Best regards
Dr. Ioana Ciuca

06.11.2013