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Grimaldi C, Brémont F, Berlioz-Baudoin M, Brouard J, Corvol H, Couderc L, Lezmi G, Pin I, Petit I, Reix P, Remus N, Schweitzer C, Thumerelle C, Dubus JC. Sweat test practice in pediatric pulmonology after introduction of cystic fibrosis newborn screening. Eur J Pediatr 2015; 174:1613-20. [PMID: 26074372 DOI: 10.1007/s00431-015-2579-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 06/02/2015] [Accepted: 06/08/2015] [Indexed: 11/25/2022]
Abstract
UNLABELLED The influence of the generalization of cystic fibrosis newborn screening (CFNBS) in France on sweat test (ST) prescription is unknown. In this French retrospective, descriptive, and multicenter study, we studied the indications, number, methods, and results of STs prescribed by a pediatric pulmonologist in children who had a negative CFNBS and an ST for respiratory symptoms in 2012. We included 502 children with 523 STs, performed with four different methods. The main indication was asthma (71.3 %), then chronic cough (52.4 %), atypical lower airway infections (42.2 %), and bronchiectasis (7 %). Four children had a diagnosis of CF (0.8 %), all presenting with chronic productive cough and recurrent respiratory infections. CONCLUSION Asthma is the most frequent indication of ST in our cohort. Because of the systematic CFNBS in France, some prescriptions should be avoided, particularly in case of severe or moderate asthma with no other associated symptom. Moreover, methods of STs often do not follow the guidelines and need standardization. WHAT IS KNOWN • Newborn screening (NBS) has become the most frequent circumstance of the diagnosis of cystic fibrosis (CF) in France after its generalization. • The prescription of sweat test (ST) in children with respiratory symptoms who already had a negative NBS has not been studied. WHAT IS NEW • In children with a negative CF NBS referred to a university hospital for respiratory diseases, despite important variations of ST methods, only 4 children among 502 have been diagnosed as CF. • Despite recommendations, ST prescription should be avoided in children with moderate to severe asthma and no other associated symptom.
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Affiliation(s)
- Céline Grimaldi
- Service de pneumologie pédiatrique et CRCM, CHU Timone, 264 rue St Pierre, 13005, Marseille, France.
| | - François Brémont
- Département de pédiatrie, Hôpital des enfants, 31026, Toulouse, France.
| | - Michèle Berlioz-Baudoin
- Service de pédiatrie et CRCM pédiatrique, Hôpitaux pédiatriques de Nice CHU-Lenval, 06200, Nice, France.
| | | | - Harriet Corvol
- Service de pédiatrie et pneumologie, Hôpital d'Enfants Armand-Trousseau, AP-HP, 75571, Paris, France.
| | - Laure Couderc
- Département de pédiatrie médicale, CHU Hôpitaux de Rouen, 76031, Rouen, France.
| | - Guillaume Lezmi
- Service de pneumologie et allergologie pédiatriques, Hôpital Necker Enfants Malades, AP-HP, 75015, Paris, France.
| | - Isabelle Pin
- Département de pédiatrie-Centre mucoviscidose, CHU de Grenoble, Hôpital Albert Michallon, 38043, Grenoble, France.
| | - Isabelle Petit
- CRCM mixte, CHU Estaing, 63003, Clermont-Ferrand, France.
| | - Philippe Reix
- Département de pneumologie pédiatrique, Hôpital Femme Mère Enfant, CHU de Lyon, 69500, Bron, France.
| | - Natacha Remus
- Département de pédiatrie, Centre Hospitalier Intercommunal de Créteil, 94010, Créteil, France.
| | - Cyril Schweitzer
- Service de médecine infantile, Hôpital d'enfants de Nancy, Rue du Morvan, 54511, Vandoeuvre-Les-Nancy, France.
| | - Caroline Thumerelle
- Service de pneumologie pédiatrique, Pôle enfant Hôpital Jeanne de Flandre, CHRU de Lille, 59037, Lille, France.
| | - Jean-Christophe Dubus
- Service de pneumologie pédiatrique et CRCM, CNRS-URMITE 6236, CHU Timone, 264 rue St Pierre, 13005, Marseille, France.
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Sermet-Gaudelus I, Munck A, Rota M, Roussey M, Feldmann D. Recommandations françaises pour la réalisation et l’interprétation du test de la sueur dans le cadre du dépistage néonatal de la mucoviscidose. Arch Pediatr 2010; 17:1349-58. [DOI: 10.1016/j.arcped.2010.06.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Accepted: 06/24/2010] [Indexed: 11/26/2022]
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