Sweat conductivity and coulometric quantitative test in neonatal cystic fibrosis screening

被引:12
作者
Domingos, Mouseline Torquato [1 ]
Rodrigues Magdalena, Neiva Isabel [2 ]
Lima Cat, Monica Nunes [2 ]
Watanabe, Alexandra Mitiru [1 ]
Rosario Filho, Nelson Augusta [2 ]
机构
[1] FEPE, SRTN, Curitiba, Parana, Brazil
[2] Univ Fed Parana UFPR, Dept Pediat, Curitiba, Parana, Brazil
关键词
Cystic fibrosis; Neonatal screening; Sweat test; Conductivity; Pilocarpine; Coulometric measurement; DIAGNOSIS; INFANTS; DISEASE; AGE;
D O I
10.1016/j.jped.2015.03.003
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective: To compare the results obtained with the sweat test using the conductivity method and coulometric measurement of sweat chloride in newborns (NBs) with suspected cystic fibrosis (CF) in the neonatal screening program. Methods: The sweat test was performed simultaneously by both methods in children with and without CF. The cutoff values to confirm CF were >50 mmol/L in the conductivity and >60 mmol/L in the coulometric test. Results: There were 444 infants without CF (185 males, 234 females, and 24 unreported) submitted to the sweat test through conductivity and coulometric measurement simultaneously, obtaining median results of 32 mmol/L and 12 mmol/L, respectively. For 90 infants with CF, the median values of conductivity and coulometric measurement were 108 mmol/L and 97 mmol/L, respectively. The false positive rate for conductivity was 16.7%, and was higher than 50 mmol/L in all patients with CF, which gives this method a sensitivity of 100% (95% CI: 93.8-97.8), specificity of 96.2% (95% CI: 93.8-97.8), positive predictive value of 83.3% (95% CI: 74.4-91.1), negative predictive value of 100% (95% CI: 90.5-109.4), and 9.8% accuracy. The correlation between the methods was r = 0.97 (p > 0.001). The best suggested cutoff value was 69.0 mmol/L, with a kappa coefficient = 0.89. Conclusion: The conductivity test showed excellent correlation with the quantitative coulometric test, high sensitivity and specificity, and can be used in the diagnosis of CF in children detected through newborn screening. (C) 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.
引用
收藏
页码:590 / 595
页数:6
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