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Diagnosing cystic fibrosis--asthma and failure to thrive as indications for a sweat test

Dan Bar-Zohar1, Danit Segal-Algranati, Amir Belson

  • 1Pediatric Gastroenterology Unit, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, 6 Weizmann St., Tel-Aviv, 64239, Israel. danir6@bezeqint.net

Journal of Medicine
|December 19, 2007
PubMed

Insights

Asthma and failure to thrive (FTT) are common reasons for cystic fibrosis (CF) testing in children. This study found FTT is a stronger indicator for CF diagnosis than asthma alone.

Area of Science:

  • Pediatric Pulmonology
  • Genetic Diseases
  • Diagnostic Testing

Background:

  • Children with asthma or failure to thrive (FTT) are often evaluated for cystic fibrosis (CF) using the quantitative pilocarpine iontophoresis sweat test (QPIT).
  • Understanding the diagnostic yield of these symptoms for CF is crucial for efficient patient management.

Purpose of the Study:

  • To compare the prevalence of asthma and FTT in children referred for QPIT.
  • To assess the relative diagnostic value of asthma versus FTT in identifying cystic fibrosis.

Main Methods:

  • Retrospective analysis of 255 children referred for QPIT between 1991-1996.
  • Standardized definitions for asthma (wheezing episodes treated with bronchodilators) and FTT (weight below 5th percentile or crossing 2 major percentiles).

Main Results:

  • Asthma was a more frequent referral indication (28.6% single, 36.5% combined) than FTT (7.1% single, 7.9% combined).
  • The prevalence of CF was higher in children with FTT (5.2%) compared to those with asthma (3%).
  • No patients diagnosed with CF were referred solely for asthma symptoms.

Conclusions:

  • Failure to thrive appears to be a more significant indicator for cystic fibrosis diagnosis than asthma when considered as a single referral reason.
  • Asthma as an isolated indication for sweat testing has a low diagnostic yield for CF.
  • Further large-scale research is recommended to validate these findings.

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