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Definition

Cystic fibrosis (or CF for short) is a genetic disorder that affects mostly the lungs, but also the pancreas, liver, kidneys, and intestines. [1] [2]

Symptoms

Long-term issues include difficulty breathing, and coughing up mucus, as a result of frequent lung infections. [1]

Other symptoms

Other signs and symptoms may include sinus infections, poor growth, fatty stool, clubbing of the fingers and toes, and infertility in most males. [1]

Cause

CF is inherited in an autosomal recessive manner. [1]

Mechanism of genetic defect

It is caused by the presence of mutations in both copies of the gene for the cystic fibrosis transmembrane conductance regulator, (or CFTR) protein. [1]

Carriers

Those with a single working copyof CFTR, are carriers, and otherwise mostly normal. [3]

Systems affected by genetic defect

CFTR is involved in the production of sweat, digestive fluids, and mucus. [4]

Effects of genetic defect

When the CFTR is not functional, secretions which are usually thin, become thick. [5]

Diagnosis

The condition is diagnosed by a sweat test, and genetic testing. [1] In parts of the world, where the defect in the gene is very common, screening of infants at birth with a sweat test may take place. [1]

Treatment

There is no known cure for cystic fibrosis, [3] and the most common complications come from lung infections.


Treatment of pneumonia

Acute lung infections are treated with antibiotics, which may be given intravenously, inhaled, or by mouth. [1]

Physiotherapy

Airway clearance techniques, such as chest physiotherapy have some short-term benefit, but the long-term effects are unclear. [6]

Prevention of lung infections

Sometimes, when someone has repeated infections, the antibiotic azithromycin is used long term. [1] Inhaled hypertonic saline, and salbutamol, may also be useful. [1]

Lung transplant

and lung transplantation may be an option, when lung function becomes very poor. [1]

Pancreatic enzyme replacement

Aside from treatment of the lungs, Pancreatic enzyme replacement ,and fat-soluble vitamin supplementation are also important, especially in the young. [1]

Prognosis

The average life expectancy, for those affected by CF, is between 42, and 50 years, in the developed world, [7] [8] with lung problems being responsible for roughly 80% of related deaths. [1]

Epidemiology

CF is most common among people of Northern European ancestry, and affects about one out of every 3,000 newborns. [1] In addition, about one in 25 people in Northern Europe is a CF gene carrier. [3] The disease is least common in Africans, and Asians. [1]

History

Cystic fibrosis was first recognized as a specific disease, by Dorothy Andersen, in 1938, although descriptions of conditions that fit the disease, have been found as far back as the year 1595. [2]

Etymology

The name "cystic fibrosis" refers to the characteristic fibrosis, and cysts, that form within the pancreas. [2] [9]

References

  1. ^ a b c d e f g h i j k l m n o O'Sullivan, BP; Freedman, SD (30 May 2009). "Cystic fibrosis". Lancet. 373 (9678): 1891–904. doi: 10.1016/s0140-6736(09)60327-5. PMID  19403164.
  2. ^ a b c Hodson, Margaret; Geddes, Duncan; Bush, Andrew, eds. (2012). Cystic fibrosis (3rd ed.). London: Hodder Arnold. p. 3. ISBN  978-1-4441-1369-3. Archived from the original on 2017-09-08.
  3. ^ a b c Massie, J; Delatycki, MB (December 2013). "Cystic fibrosis carrier screening". Paediatric Respiratory Reviews. 14 (4): 270–5. doi: 10.1016/j.prrv.2012.12.002. PMID  23466339.
  4. ^ Buckingham, Lela (2012). Molecular diagnostics fundamentals, methods, and clinical applications (2nd ed.). Philadelphia: F.A. Davis Co. p. 351. ISBN  978-0-8036-2975-2. Archived from the original on 2017-09-08.
  5. ^ Yankaskas JR, Marshall BC, Sufian B, Simon RH, Rodman D (2004). "Cystic fibrosis adult care consensus conference report". Chest. 125 (90010): 1–39. CiteSeerX  10.1.1.562.1904. doi: 10.1378/chest.125.1_suppl.1S. PMID  14734689.
  6. ^ Warnock, L.; Gates, A. (21 December 2015). "Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis". The Cochrane Database of Systematic Reviews (12): CD001401. doi: 10.1002/14651858.CD001401.pub3. PMID  26688006.
  7. ^ Ong, T; Ramsey, BW (15 September 2015). "Update in Cystic Fibrosis 2014". American Journal of Respiratory and Critical Care Medicine. 192 (6): 669–75. doi: 10.1164/rccm.201504-0656UP. PMID  26371812.
  8. ^ Nazareth, D; Walshaw, M (October 2013). "Coming of age in cystic fibrosis - transition from paediatric to adult care". Clinical Medicine. 13 (5): 482–6. doi: 10.7861/clinmedicine.13-5-482. PMC  4953800. PMID  24115706.
  9. ^ Andersen DH (1938). "Cystic fibrosis of the pancreas and its relation to celiac disease: a clinical and pathological study". Am J Dis Child. 56 (2): 344–399. doi: 10.1001/archpedi.1938.01980140114013.