Clinical profile and molecular diagnosis of Cystic Fibrosis
Joint Event on 15th World Congress on Pediatrics, Clinical Pediatrics and Nutrition & 28th International Conference on Nursing Practice
November 28-29, 2018 | Dubai, UAE
Pramila Menon, S D Gangane and Mrudula Phadke
Maharashtra University of Health Sciences, India
Scientific Tracks Abstracts : Curr Pediatr Res
This is a study conducted with aim to understand clinical
profile and molecular diagnosis of suspected cystic fibrosis
CF) in Maharashtra, India over a period of three years from
January 2012 to December 2014 in the Genetic laboratory of
Maharashtra University of Health Sciences (MUHS), Regional
Centre Pune. All (n=113) were tested for DF508 mutation at
our laboratory followed by 5 mutational analysis at Hinduja
Laboratory Mumbai(n=25). This study focuses on identifying
common symptoms and clinical signs of cystic fibrosis so that
physicians will be able to identify the disease in the early stage.
We included children with signs and symptoms of cystic fibrosis
like failure to thrive, chronic diarrhea, recurrent pneumonia,
newborn with meconium ileus, adults with infertility and
excluded HIV positive, Tuberculosis, and malignancy patients.
The most common presentation of suspected cystic fibrosis
was malnutrition followed by recurrent respiratory infection.
In our study group, the age ranged from newborn 1 day to 39
years. Our study also includes29 cases (25.66%) who were less
than 1 year which suggests good awareness of cystic fibrosis
in physicians even in the absence of a neonatal screening
protocol in Maharashtra. These infants were referred based
on clinical suspicion. We found malnutrition in 87.75% in
0-18 years age group and 90.47% malnutrition in less than 1
year. We had 28.5% Pneumonia cases and 6.3% cases with
bronchiectasis. We found DF 508 mutation in only 4 patients.
We found the frequency of DF508 as 6.34% in suspected cystic
fibrosis cases in Maharashtra. This is lower than the other
reports from India, Kabra et al 2003 (n=120) 19%, Ashavaid
et al 2012(n=96) 53% and Mir et al 33.3%. This may be due
to inclusion of all suspected cystic fibrosis cases in our study
without considering the results of sweat chloride test. Sweat
chloride test was done in only 22.2% cases. Sweat chloride test
was positive in 35.7% of the suspected cystic fibrosis cases.
One of the important cases, 2 years old male child presenting
with negative sweat chloride test with recurrent Pneumonia/
Chronic Diarrhea/ Anemia was positive for DF508.This brings
out very important fact that any child with multisystemic
involvement with malnutrition in spite of sweat chloride test
results should be subjected for detection of CFTR mutations.
History of consanguity was present in 15.9% and in 7.9%
suspected cystic fibrosis cases gave family history of death of
siblings.DF508 mutation against gold standard sweat chloride
test we found sensitivity 20% and specificity 85.7%. Our study
also found DF 508 positive status in 8% of male infertility cases.
Conclusion: We found the most common presentation of suspected cystic fibrosis was malnutrition followed by recurrent respiratory infection and DF508 is not the common mutation in Maharashtra. Probably our mutation profile is different, more detailed study is warranted. The possibility of missing cystic fibrosis cases due to lack of genetic testing services like sweat chloride testing cannot be ruled out.
Pramila Menon has completed her PhD at the age of 54 years from Maharashtra University of Health Sciences, Nashik. She is the Sate Consultant in Infant Young Child and Adjunct Professor at Dr D Y Patil Medical College Pune. She worked as Associate Professor at Maharashtra University of Health Sciences (MUHS), Regional Centre Pune. She has over 20 publications.
E-mail: [email protected]