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Quality of sweat test (ST) based on the proportion of sweat sodium (Na) and sweat chloride (Cl) as diagnostic parameter of cystic fibrosis: are we on the right way?

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Faria, Alethea Guimaraes ; Lima Marson, Fernando Augusto ; de Souza Gomez, Carla Cristina ; Goncalves de Oliveira Ribeiro, Maria Angela ; Morais, Lucas Brioschi ; Servidoni, Maria de Fatima ; Bertuzzo, Carmen Silvia ; Sakano, Eulalia ; Goto, Maura ; Paschoal, Ilma Aparecida ; Pereira, Monica Corso ; Hessel, Gabriel ; Levy, Carlos Emilio ; Dalbo Contrera Toro, Adyleia Aparecida ; Peixoto, Andressa Oliveira ; Ribeiro Simoes, Maria Cristina ; Lomazi, Elizete Aparecida ; Negrao Nogueira, Roberto Jose ; Ribeiro, Antonio Fernando ; Ribeiro, Jose Dirceu
Número total de Autores: 20
Tipo de documento: Artigo Científico
Fonte: DIAGNOSTIC PATHOLOGY; v. 11, OCT 26 2016.
Citações Web of Science: 3
Resumo

Background: To assess the quality of sweat test (ST) based on the proportion of sweat sodium and sweat chloride as diagnostic parameter of cystic fibrosis (CF). Methods: A retrospective study of 5,721 sweat samples and subsequent descriptive analysis were carried out. The test was considered ``of good quality{''} (correct) when: (i) sweat chloride was lower than 60 mEq/L, and sweat sodium was higher than sweat chloride; (ii) sweat chloride was higher than 60 mEq/L, and sweat sodium was lower than sweat chloride. Results: The study included 5,692/5,721 sweat samples of ST which had been requested due to clinical presentations compatible with CF and/or neonatal screenings with altered immunoreactive trypsinogen values. Considering the proportion of sweat sodium and sweat chloride as ST quality parameter, the test was performed correctly in 5,023/5,692 (88.2 %) sweat samples. The sweat chloride test results were grouped into four reference ranges for chloride (i) chloride >= 30 mEq/L: 3,651/5,692 (64.1 %); (ii) chloride < 30 mEq/L to < 40 mEq/L: 652/5,692 (11.5 %); (iii) >= 40 mEq/L to < 60 mEq/L: 673/5,692 (11.8 %); (iv) >= 60 mEq/L: 716/5,692 (12.6 %). In the comparative analysis, there was no association between ST quality and: (i) symptoms to indicate a ST {[}respiratory (p = 0.084), digestive (p = 0.753), nutritional (p = 0.824), and others (p = 0.136)], (ii) sweat weight (p = 0.416). However, there was a positive association with: (i) gender, (ii) results of ST (p < 0.001), (iii) chloride/sodium ratio (p < 0.001), (iv) subject's age at the time of ST {[}grouped according to category (p < 0.001) and numerical order (p < 0.001)]. For the subset of 169 patients with CF and two CFTR mutations Class I, II and/or III, in comparative analysis, there was a positive association with: (i) sweat chloride/sodium ratio (p < 0.001), (ii) sweat chloride values (p = 0.047), (iii) subject's age at the time of the ST grouped by numerical order (p = 0.001). Conclusions: Considering that the quality of ST can be assessed by levels of sweat sodium and sweat chloride, an increasing number of low-quality tests could be observed in our sweat samples. The quality of the test was associated with important factors, such as gender, CF diagnosis, and subjects' age. (AU)

Processo FAPESP: 11/12939-4 - Associação entre polimorfismos de genes moduladores em crianças e adolescentes com asma alérgica e não alérgica - leve, moderada e grave
Beneficiário:Fernando Augusto de Lima Marson
Linha de fomento: Bolsas no Brasil - Doutorado
Processo FAPESP: 15/12858-5 - Identificação das mutações prevalentes e caracterização clínica e funcional de crianças e adultos com discinesia ciliar primária
Beneficiário:Fernando Augusto de Lima Marson
Linha de fomento: Bolsas no Brasil - Pós-Doutorado
Processo FAPESP: 11/18845-1 - Associação entre polimorfismos de genes moduladores em crianças e adolescentes com asma alérgica e não alérgica leve, moderada e grave
Beneficiário:Jose Dirceu Ribeiro
Linha de fomento: Auxílio à Pesquisa - Regular