Journals / Turkish Journal of Gastroenterology / 2013 / Cilt: 24 - Sayı: 6

Kistik fibrozisin tanı anındaki klinik prezentasyonu: Yeni doğan taraması olmayan bir bölgede çok merkezli çalışma

Clinical presentation of cystic fibrosis at the time of diagnosis: a multicenter study in a region without newborn screening

Pages
541–545
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In these regions, awareness and clinical suspicion of medical professionals are crucial for early diagnosis of cystic fibrosis patients in the pre-diagnostic period.

📌 3 Key Takeaways

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Objective & Hypothesis:Background/aims: Cystic fibrosis is the most common inherited lethal disease, which could be frequently identified late in regions without newborn screening.
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Key Findings & Data:Among them, 119 patients (74%) were less than six months and 34 patients (21%) were between 6 and 12 months of age.
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Conclusion & Impact:In these regions, awareness and clinical suspicion of medical professionals are crucial for early diagnosis of cystic fibrosis patients in the pre-diagnostic period.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Background/aims: Cystic fibrosis is the most common inherited lethal disease, which could be frequently identified late in regions without newborn screening. There are dramatically better outcomes in the early diagnosis of cystic fibrosis patients. This studyaimed to evaluate the spectrum of manifestations of cystic fibrosis at first admission leading to diagnosis. Materials and Methods:This study was performed in a multi-referral pediatrics center in Iran. Data of patients with cystic fibrosis at the time of diagnosis were recorded based on a checklist denoting demographic characteristics, clinical and laboratory features. All of the patients had two documented sweat chloride tests. Results: One hundred and ninety seven patients with cystic fibrosis were enrolled in this study. Among them, 119 patients (74%) were less than six months and 34 patients (21%) were between 6 and 12 months of age. The most common clinical findings were failure to thrive, recurrent pulmonary infections, and steatorrhea in 178 (90%), 139 (71%), and 135 (69%) patients, respectively. The most common radiologic abnormality was hyperaeration. In patients with salty tasting skin, steatorrhea, metabolic alkalosis, radiologic findings, and liver function abnormalities, the mean age at the time of diagnosis was significantly low than in the subjects without these findings. Conclusion: This study suggests that some conditions such as failu- re to thrive, recurrent respiratory infections, steatorrhea, metabolic alkalosis, and salty tasting skin should be considered as clini- cal screening tools for cystic fibrosis, especially in regions with high rate of cystic fibrosis. In these regions, awareness and clinical suspicion of medical professionals are crucial for early diagnosis of cystic fibrosis patients in the pre-diagnostic period.

Özet

Giriş ve Amaç: Kistik fibrozis en sık karşılaşılan kalıtımsal ölümcül hastalıktır ve yenidoğan taramasnın yapılmadığı bölgelerde hastalar geç tespit edilebilir. Erken tanı konulan kistik fibrozis hastalarının sonuçları dramatik olarak daha iyidir. Bu çalışmada kistik fibrozis hastalarında ilk başvuruda tespit edilen tanıya götüren bulgularının incelenmesi amaçlanmıştır. Gereç ve Yöntem: Bu çalışma İran\'da birden çok pediatrik referans merkezinde gerçekleştirildi, hastalarn tanı anındaki demografik, klinik ve labaratuvar verileri kontrol listesi ile kayıt altına alındı. Tüm hastaların 2 adet ter klor testi mevcuttu. Bulgular: Kistik fibrozis tanısı olan 197 hasta çalışmaya dahil edildi. Bu hastalardan, 119\'unun (%74) yaşı 6 aydan küçüktü ve 34 hastanın (%21) yaşı 6-12 ay arasındaydı. En sık karşılaşılan klinik bulgular büyüme geriliği (n=178; %90) , tekrarlayan akciğer enfeksiyonları (n=139; %71) ve steatore (n=135; %69) olarak tespit edildi. En sık karşılaşılan radyolojik anormallik akciğerlerde aşırı havalanmaydı. Terde tuz tadı, steatore, metabolik alkaloz, radyolojik anormallikler ve karaciğer testlerinde anormallik olan hastaların ortalama tanı yaşı diğerlerine göre düşük bulundu. Sonuç: Bu çalışma sonuçlarına göre büyüme geriliği, tekrarlayan solunum sistemi enfeksiyonu, steatore, metabolik alkaloz ve tuzlu cilt tadı kistik fibrozis ile sık karşılaşılan bölgelerde klinikte uyarıcı olmalıdır. Bu bölgelerde, dikkat ve klinik şüphe ile hastaların erken tespit edilmesi mümkün olabilir.

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Cite This Article

FARAHMAND, F., KHALILI, M., SHAHBAZNEJAD, L., HIRBOD-MOBARAKEH, A., NAJAFI, M. S., KHODADAD, A., MOTAMED, F., REZAEI, N. (2013). Kistik fibrozisin tanı anındaki klinik prezentasyonu: Yeni doğan taraması olmayan bir bölgede çok merkezli çalışma. Turkish Journal of Gastroenterology, Cilt: 24 - Sayı: 6, 541–545. https://ajindex.com/articles/409584

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References (16)

  1. Ratjen F, Doring G. Cystic fibrosis. Lancet 2003; 361:681- 9
  2. Kerem E, Conway S, Elborn S, Heijerman H. Standards of care for patients with cystic fibrosis: a European consen- sus. J Cyst Fibros 2005; 4:7-26
  3. Farrell PM, Lai HJ, Li Z, et al. Evidence on improved out- comes with early diagnosis of cystic fibrosis through neona- tal screening: enough is enough! J Pediatr 2005; 147:S30-6
  4. Farrell PM, Kosorok MR, Laxova A, et al. Nutritional bene- fits of neonatal screening for cystic fibrosis. Wisconsin Cystic Fibrosis Neonatal Screening Study Group. N Engl J Med 1997; 337:963-9
  5. Dankert-Roelse JE, te Meerman GJ. Long term prognosis of patients with cystic fibrosis in relation to early detection by neonatal screening and treatment in a cystic fibrosis centre. Thorax 1995; 50:712-8
  6. Sims EJ, Clark A, McCormick J, et al. Cystic fibrosis diag- nosed after 2 months of age leads to worse outcomes and re- quires more therapy. Pediatrics 2007; 119:19-28
  7. Farrell PM. The meaning of "early" diagnosis in a new era of cystic fibrosis care. Pediatrics 2007; 119:156-7
  8. Grosse SD, Boyle CA, Botkin JR, et al. Newborn screening for cystic fibrosis: evaluation of benefits and risks and re- commendations for state newborn screening programs. MMWR Recomm Rep 2004; 53:1-36
  9. Shah U, Frossard P, Moatter T. Cystic fibrosis: defining a disease under-diagnosed in Pakistan. Trop Med Int Health 2009; 14:542-5
  10. Lotem Y, Barak A, Mussaffi H, et al. Reaching the diagno- sis of cystic fibrosis--the limits of the spectrum. Isr Med As- soc J 2000; 2:94-8
  11. Najada AS, Dahabreh MM. Clinical profile of cystic fibro- sis. Atypical presentation. Saudi Med J 2010; 31:185-8
  12. Fallahi G, Najafi M, Farhmand F, et al. The clinical and la- boratory manifestations of Iranian patients with cystic fib- rosis. Turk J Pediatr 2010; 52:132-8
  13. Banjar H. Mortality data for cystic fibrosis patients in a tertiary care center in Saudi Arabia. Ann Saudi Med 2003; 23:416-7
  14. Gibson LE, Cooke RE. A test for concentration of electroly- tes in sweat in cystic fibrosis of the pancreas utilizing pilo- carpine by iontophoresis. Pediatrics 1959; 23:545-9
  15. Gibson GJ. Pulmonary hyperinflation a clinical overview. Eur Respir J 1996; 9:2640-9
  16. Kliegman RM, Jensen HB, Stanton BF, et al. Nelson text book of pediatrics ed 18, Philadelphia: Saunders; 2007. 17. van Dommelen P, Grote FK, Oostdijk W, et al. Growth mo- nitoring to detect children with cystic fibrosis. Horm Res 2009;