Fibrosis cystic E84.8

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

cystic fibrosis; Cystic fibrosis; Cystic pancreatic fibrosis; Dysporia entero-broncho-pancreatica congenita; Dysporia entero-bronchopancreatica congenita familiaris; mucoviscidosis

History
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Andersen, 1938

Definition
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Cystic-fibrous changes in pancreas and lungs caused by congenital increased viscosity of secretions of all exocrine glands.

Occurrence/Epidemiology
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Most common autosomal recessive inherited disease in people of white skin colour (1:2500).

Etiopathogenesis
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mutation on chromosome 7 for the "Cystic Fibrosis Transmembrane Regulator" (CFTR genes).

Clinical features
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  • Integument: Skin lesions are present inconstantly. From the 3rd-4th month of life on, there are blurred, scaly, perioral erythema. In rare cases the development of erythroderma is possible.
  • Extracutaneous manifestations: cystic pancreatic fibrosis, meconium ileus, bronchiectasis, recurrent bronchopneumonia, pulmonary abscesses, focal liver fibrosis, malnutrition, growth arrest.

Diagnosis
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High electrolyte concentration in sweat. Sodium > 80 mval/ml is suspicious. Absence of pancreatic enzymes in duodenal juice. Molecular genetic analysis.

Therapy
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Recommended are continuous antibiotic therapy for respiratory infections, enzyme substitution, reduction of the fat supply, adequate fluid and saline intake.

Progression/forecast
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Awkward. Mean life expectancy: 25 years; death due to heart failure in case of pulmonary circulation overload.

Literature
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  1. Andersen DH (1938) Studies on glycogen disease with a report of a case in which the glycogen was abnormal. Am J Dis Child (Chicago) 56: 344
  2. Andersen DH (1956) Familial cirrhosis of the liver with storage of abnormal glycogen. Lab Invest (Baltimore) 5: 11-20
  3. Baker SS et al (2005) Pancreatic enzyme therapy and clinical outcomes in patients with cystic fibrosis. J Pediatr 146: 189-193
  4. Orenstein DM et al (2002) Cystic fibrosis: a 2002 update. J Pediatr 140: 156-164
  5. Ratjen F, Doring G (2003) Cystic fibrosis. Lancet 361: 681-689

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Last updated on: 29.10.2020