EVALUATION OF THE SWEAT CHLORIDE ASSAY IN ADULTS: USE OF PILOCARPINE IONTOPHORESIS*

Journal/Book: The American Journal of the Medical Sciences Vol. 246 No. 5 November 1963. 1963;

Abstract: BY- JACK LIEBERMAN M.D. FORMERLY VETERANS ADMINISTRATION CLINICAL INVESTIGATOR; PRESENTLY SECTION CHIEF GENERAL MEDICINE VETERANS ADMINISTRATION HOSPITAL LONG BEACH CALIFORNIA ASSISTANT CLINICAL PROFESSOR OF MEDICINE UNIVERSITY OF CALIFORNIA AT LOS ANGELES MEDICAL CENTER LOS ANGELES CALIFORNIA AND FREDERICK KELLOGG M.D. CLINICAL PROFESSOR OF MEDICINE UNIVERSITY OF CALIFORNIA AT LOS ANGELES MEDICAL CENTER LOS ANGELES CALIFORNIA WITH THE TECHNICAL ASSISTANCE OF B. AUSTIN PRUITT (From The Veterans Administration Hospital Long Beach and The Department of Medicine University of California Medical Center Los Angeles California) This study was aided by a grant from the National Cystic Fibrosis Research Foundation New York N.Y. Summary. The pilocarpine iontophoresis technique and a Cotlove Chloridometer were utilized for obtaining and assaying the chloride content of sweat in 142 normal adults 57 normal children 31 cystic fibrosis patients 59 parents of children with cystic fibrosis 57 siblings of children with cystic fibrosis and 80 adult males with chronic lung disease. The resulting data suggests that the normal adult population is in fact a bimodal population with the majority of individuals demonstrating sweat chloride values of less than 40 mEq. per L. and about 15.5 of the population showing higher values. This bimodal distribution curve was not seen in children. Parents of cystic fibrosis patients and adult males with chronic lung disease showed a larger percentage of individuals in the "high-chloride" population than did the normal controls. The possible significance of the bimodal distribution of sweat chloride in adults is discussed. It is concluded that the sweat chloride assay performed in this manner is an excellent and simple procedure for confirming a diagnosis of cystic fibrosis. The test is of limited usefulness for detecting heterozygotes or carriers of the cystic fibrosis gene. ___MH

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