Limitations of diagnostic value of the sweat test. 1977

V Schwarz, and N I Simpson, and A S Ahuja

The sweat test, even if carried out by an experienced technician, sometimes lacks reproducibility owing presumably to physiological variations (patient's diet, temperature, and other factors at present unrecognized). Some patients are particularly prone to exhibit this variability and in them a single sweat test is almost valueless. The aldosterone status is believed to be responsible for a reciprocal relationship between sweat sodium and potassium concentrations: tests done on 8 patients show that a high sweat potassium is associated with a correspondingly lower sodium--a circumstance which must be borne in mind when interpreting a patient's sweat sodium. Of 30 patients presenting with a variety of symptoms compatible with a diagnosis of cystic fibrosis and with sweat sodium ranging from 50 to 75 mEq/1 (50-75 mmol/1), only 4 have proved to have cystic fibrosis after several years of observations; 13 have later been diagnosed as having asthma. The problem of the 'grey area' of uncertainty is aggravated by the heterozygous state which is also associated with a sweat sodium in this range. Repeated sweat tests are indicated if the sweat sodium lies within the 'grey area', and the diagnostic importance accorded the test should diminish as the sodium value approaches this area. The diagnosis of cystic fibrosis must remain in doubt unless there is strong supportive clinical evidence.

UI MeSH Term Description Entries
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003550 Cystic Fibrosis An autosomal recessive genetic disease of the EXOCRINE GLANDS. It is caused by mutations in the gene encoding the CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATOR expressed in several organs including the LUNG, the PANCREAS, the BILIARY SYSTEM, and the SWEAT GLANDS. Cystic fibrosis is characterized by epithelial secretory dysfunction associated with ductal obstruction resulting in AIRWAY OBSTRUCTION; chronic RESPIRATORY INFECTIONS; PANCREATIC INSUFFICIENCY; maldigestion; salt depletion; and HEAT PROSTRATION. Mucoviscidosis,Cystic Fibrosis of Pancreas,Fibrocystic Disease of Pancreas,Pancreatic Cystic Fibrosis,Pulmonary Cystic Fibrosis,Cystic Fibrosis, Pancreatic,Cystic Fibrosis, Pulmonary,Fibrosis, Cystic,Pancreas Fibrocystic Disease,Pancreas Fibrocystic Diseases
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D001249 Asthma A form of bronchial disorder with three distinct components: airway hyper-responsiveness (RESPIRATORY HYPERSENSITIVITY), airway INFLAMMATION, and intermittent AIRWAY OBSTRUCTION. It is characterized by spasmodic contraction of airway smooth muscle, WHEEZING, and dyspnea (DYSPNEA, PAROXYSMAL). Asthma, Bronchial,Bronchial Asthma,Asthmas
D012964 Sodium A member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. Sodium Ion Level,Sodium-23,Ion Level, Sodium,Level, Sodium Ion,Sodium 23
D013542 Sweat The fluid excreted by the SWEAT GLANDS. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. Sweats
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor

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