Diagnosis of cystic fibrosis during adolescence

The manifestations of cystic fibrosis (CF) may be minimal, absent, or overlooked during childhood, thus 8-10% of cases are diagnosed during adolescence. Between 1970 and 1982, 14/157 (8.9%) patients were diagnosed as having CF as teenagers, based on clinical findings and elevated sweat electrolyte levels. Of these 14 patients (means = 15 years, range = 12-20 years), 50% had pulmonary and gastrointestinal symptoms dating from childhood; 50% became symptomatic during adolescence (primarily with pulmonary manifestations). None had a family history of CF. Four had false-negative sweat tests resulting in a mean diagnostic delay of 7.3 years. Because of the potential long-term complications of CF on physical maturation, completion of the psychosocial tasks of adolescence, adaptation to a chronic illness, and issues of sexuality and fertility, consideration of this diagnosis is crucial.