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Cystic fibrosis in blacks in Washington, DC: fifteen years' experience
Insights
Cystic Fibrosis (CF) presentation in Black Americans shows similarities to White Americans in diagnosis age and symptoms, but Black patients had lower weight at diagnosis. Early suspicion is crucial for timely CF diagnosis in all populations.
Area of Science:
- Medical Research
- Pediatrics
- Genetics
Background:
- Cystic Fibrosis (CF) is a genetic disorder affecting multiple organs.
- Clinical presentation of CF in Black Americans is not well-defined, leading to diagnostic challenges.
Purpose of the Study:
- To compare the clinical characteristics of Cystic Fibrosis (CF) in Black and White American patients.
- To identify potential racial disparities in CF presentation and diagnosis.
Main Methods:
- Retrospective chart review of 188 CF patients (1971-1986).
- Comparison of age at diagnosis, symptom duration, presenting symptoms, sputum cultures, and anthropometrics between racial groups.
- Statistical analysis to determine significant differences.
Main Results:
- No significant differences found in age at diagnosis, symptom duration, sweat electrolyte concentrations, or sputum cultures between Black and White patients.
- Black patients were more likely to present with only pulmonary symptoms (40% vs. 22%).
- White patients were more likely to present with only gastrointestinal symptoms (46% vs. 35%).
- Age-adjusted weight percentiles at diagnosis were significantly lower for Black patients compared to White patients (P <= 0.05).
Conclusions:
- While Cystic Fibrosis (CF) is less common in Black Americans, clinical presentation shares similarities with White Americans.
- Racial disparities exist in presenting symptoms and nutritional status at diagnosis.
- A high index of suspicion is essential for early diagnosis of CF in Black children.
Abstract:
Controversies exist regarding the clinical presentation and characteristics of cystic fibrosis (CF) in American blacks. Between 1971 and 1986, 188 patients with CF (165 whites, 20 blacks, and 3 others) seen at Children's Hospital National Medical Center, Washington, DC, were evaluated for age at diagnosis, duration of symptoms prior to diagnosis, clinical presentations, initial sputum culture results, and weight and height at diagnosis. Comparisons between black and white patients revealed no statistically significant differences in average age at diagnosis, average duration of symptoms prior to diagnosis, average sweat electrolyte concentrations, or sputum culture results. A breakdown of presenting symptoms by race showed some points of disparity. About twice as many black patients as white patients (40% v 22%) presented with only pulmonary symptoms, whereas slightly more whites presented with only gastrointestinal symptoms (46% v 35%). Those patients presenting with a combination of symptomatology were equally distributed by race (25% black, 21% white). At diagnosis, age-adjusted weight percentiles were significantly lower for black patients than for white patients (chi 2 = 9.60, P less than or equal to 0.05). Although the authors agree that CF is relatively rare among blacks, a high index of suspicion is essential for early diagnosis.