Pediatric Department, Faculty of Medicine, Cairo University, Egypt.
Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Egypt.
J Adv Res. 2014 Sep;5(5):563-8. doi: 10.1016/j.jare.2013.07.005. Epub 2013 Jul 15.
It was generally believed that Cystic fibrosis (CF) is rare among Arabs; however, the few studies available from Egypt and other Arabic countries suggested the presence of many undiagnosed patients. The aim of the present study was to determine the frequency of CF patients out of the referred cases in a single referral hospital in Egypt. A total of 100 patients clinically suspected of having CF were recruited from the CF clinic of the Allergy and Pulmonology Unit, Children's Hospital, Cairo University, Egypt, throughout a 2 year period. Sweat chloride testing was done for all patients using the Wescor macroduct system for collection of sweat. Quantitative analysis for chloride was then done by the thiocyanate colorimetric method. Patients positive for sweat chloride (⩾60 mmol/L) were tested for the ΔF508 mutation using primer specific PCR for cystic fibrosis transmembrane conductance regulator (CFTR) gene. Thirty-six patients (36%) had a positive sweat chloride test. The main clinical presentations in patients were chronic cough in 32 (88.9%), failure to thrive in 27 (75%), steatorrhea in 24 (66.7%), and hepatobiliary involvement in 5 (13.9%). Positive consanguinity was reported in 50% of CF patients. Thirty-two patients were screened for ΔF508 mutation. Positive ΔF508 mutation was detected in 22 (68.8%) patients, 8 (25%) were homozygous, 14 (43.8%) were heterozygous, and 10 (31.3%) tested were negative. CF was diagnosed in more than third of patients suspected of having the disease on clinical grounds. This high frequency of CF among referred patients indicates that a high index of suspicion and an increasing availability of diagnostic tests lead to the identification of a higher number of affected individuals.
普遍认为囊性纤维化(CF)在阿拉伯人中很少见;然而,来自埃及和其他阿拉伯国家的少数研究表明,存在许多未确诊的患者。本研究的目的是确定埃及一家转诊医院中转诊病例中 CF 患者的频率。在埃及开罗大学儿童医院过敏和肺病科的 CF 诊所,在 2 年期间共招募了 100 名临床疑似 CF 的患者。所有患者均使用 Wescor 大管系统进行汗液氯化物检测。然后通过硫氰酸盐比色法对氯化物进行定量分析。汗液氯化物阳性(⩾60mmol/L)的患者用 CF 跨膜电导调节蛋白(CFTR)基因的引物特异性 PCR 检测 ΔF508 突变。36 名患者(36%)汗液氯化物检测阳性。患者的主要临床表现为慢性咳嗽 32 例(88.9%)、生长不良 27 例(75%)、脂肪泻 24 例(66.7%)和肝胆受累 5 例(13.9%)。50%的 CF 患者有阳性近亲结婚史。对 32 名患者进行 ΔF508 突变筛查。在 22 名(68.8%)患者中检测到阳性 ΔF508 突变,8 名(25%)为纯合子,14 名(43.8%)为杂合子,10 名(31.3%)检测结果为阴性。根据临床诊断怀疑患有该疾病的患者中,有超过三分之一被诊断为 CF。转诊患者中 CF 的高频率表明,高度怀疑和越来越多的诊断检测可导致更多受影响个体的识别。