Sweat tests to diagnose cystic fibrosis in adults.

Hodson, M E; Beldon, I; Power, Richard G; Duncan, F R; Bamber, M.; Batten, John

doi:10.1136/bmj.286.6375.1381

Cited by 53 publications

(6 citation statements)

References 7 publications

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“…The diagnosis of CF is also increasingly being made in adults, as mild phenotypes are being recognized. Sweat electrolyte concentrations have been reported to gradually increase with age [7,9], and normal (non-CF) subjects may have sweat chloride concentrations between 60 and 80 mmol/L [10]. To complicate the interpretation, those diagnosed with CF as adults tend to have lower sweat chloride levels than those diagnosed as children [11].…”

Section: Introductionmentioning

confidence: 99%

Relationship between sweat chloride, sodium, and age in clinically obtained samples

Traeger

Shi

Dozor

2014

Journal of Cystic Fibrosis

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Section: Introductionmentioning

confidence: 99%

Relationship between sweat chloride, sodium, and age in clinically obtained samples

Traeger

Shi

Dozor

2014

Journal of Cystic Fibrosis

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“…Sweat tests were performed by pilocarpine iontophoresis [11] and individuals with high borderline values of sodium (60±80 mmol . L -1 ) had a repeat sweat test after pre-treatment with fludrocortisone 5 mg daily for 2 days [12]. Nasal potential differences were measured by the technique described by ALTON et al [13].…”

Section: Study Protocolmentioning

confidence: 99%

Determinants of chronic infection with Staphylococcus aureus in patients with bronchiectasis

Shah¹,

Mawdsley²,

Nash³

et al. 1999

Eur Respir J

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Staphylococcus aureus is an uncommon pathogen in bronchiectasis not caused by cystic fibrosis (CF). The object of this study was to identify characteristics that cause patients to be prone to infection with S. aureus.The study population consisted of patients with bronchiectasis attending the authors' unit, excluding those with a diagnosis of overt CF. All patients had a high resolution computer tomographic scan (HRCT) of the thorax which demonstrated bronchiectasis. Cases that were currently chronically infected with S. aureus (isolated consecutively on more than two occasions >3 months apart) were identified (n=12) and compared with 74 control patients who had not been chronically infected with S. aureus. Patients were carefully evaluated to determine the aetiology of their disease. Odds ratios (OR) and 95% confidence intervals (CI) as measures of the association between disease characteristics and chronic infection with S. aureus were calculated.The results for patients chronically infected by S. aureus demonstrated significant associations with allergic bronchopulmonary aspergillosis (ABPA; OR=8.8, 95% CI 1.8±41.9), atypical variants of CF (OR=12.0, 95% CI 1.8±81.7) or equivocal sweat sodium values (OR=4.0, 95% CI 1.0±15.3). The associations persisted when the analysis was based on cases (n=28) in whom S. aureus had ever been isolated from sputum. In the latter analysis there was also a significant association with predominant upper zone disease on HRCT.These results suggest that patients with bronchiectasis in whom S. aureus is isolated from sputum should be carefully evaluated to exclude allergic bronchopulmonary aspergillosis or atypical cystic fibrosis. Eur Respir J 1999; 14: 1340±1344. Staphylococcus aureus is a gram positive coccus which is only occasionally cultured from the sputum of patients with bronchiectasis [1], whereas in patients with cystic fibrosis (CF) it is almost always the initial bacterial infection [2±4]. In CF S. aureus infection may stimulate an inflammatory response that causes lung damage and facilitates subsequent chronic infection with Pseudomonas aeruginosa [2±4]. Once chronic infection with P. aeruginosa has occurred S. aureus is less frequently cultured and it has been suggested that this is due to anti-staphylococcal factors produced by P. aeruginosa [5]. Several reports of sputum microbiology and bronchoscopic sampling suggest that S. aureus occurs in~4±10% of patients with non-CF bronchiectasis [6±8]. The reason for this difference in the type of bacterial infective organisms is unclear. The object of the present study was to identify common characteristics of a group of patients with non-CF bronchiectasis who were chronically infected with S. aureus. Methods Study definitionsChronic infection with S. aureus was defined as patients who were infected with S. aureus during the study period and the bacterium had been isolated from consecutive sputum samples taken on more than two occasions >3 months apart. Intermittent infection with S. aureus was defined when the ba...

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“…In healthy individuals the sweat Na values have been reported to fall significantly after fludrocortisone priming. 10 However the recent UK guidelines for the performance of the sweat test suggest that there is no routine place for this test due to paucity of data.…”

Section: Discussionmentioning

confidence: 99%