Cystic fibrosis

Cystic fibrosis is an inherited disease that causes thick, sticky mucus to build up in the lungs and digestive tract. It is the most common type of chronic lung disease in children and young adults, and may result in early death.

Manifestations of cystic fibrosis

Causes, incidence, and risk factors

Cystic fibrosis (CF) is caused by a defective gene which tells the body to produce abnormally thick and sticky fluid, called mucus. This mucus builds up in the breathing passages of the lungs and the pancreas, the organ that helps to break down and absorb food. This collection of sticky mucus results in life-threatening lung infections and serious digestion problems. The disease may also affect the sweat glands and a man's reproductive system.

Millions of Americans carry the defective CF gene, but do not have any symptoms. That's because a person with CF must inherit two defective CF genes -- one from each parent. An estimated 3% to 10% of Caucasians have the CF gene. The disease is the most common, deadly, inherited disorder affecting Caucasians in the United States. It's more common among those of Northern or Central European descent.

Most children are diagnosed with CF by their 1st birthday. A small number, however, are not diagnosed until age 18 or older. These patients usually have a milder form of the disease.

Symptoms

Because there are more than 1,000 mutations of the CF gene, symptoms differ from person to person. But in general they include:

• No bowel movements in first 24 to 48 hours of life
• Stools that are pale or clay colored, foul smelling, or that float
• Infants may have salty-tasting skin
• Recurrent respiratory infections, such as pneumonia or sinusitis
• Coughing or wheezing
• Weight loss, or failure to gain weight normally in childhood
• Diarrhea
• Delayed growth
• Fatigue

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Clubbing in cystic fibrosis

Signs and tests

In May 2005, the U.S. Food and Drug Administration approved the first DNA-based blood test to help detect CF. The test looks for variations in a gene known to cause the disease. Other tests use to diagnose CF include:

• Sweat chloride test. This is the standard diagnostic test for CF. A high salt level in the patient's sweat indicates the disease.
• Fecal fat test
• Upper GI and small bowel series
• Measurement of pancreatic function
• Cystic fibrosis may alter the results of the following tests:

• Trypsin and chymotrypsin in stool
• Secretin stimulation test
• Chest x-ray or CT scan
• Lung function test

Treatment

An early diagnosis of CF and a comprehensive treatment plan can improve both survival and quality of life. Specialty clinics for cystic fibrosis may be helpful and can be found in many communities.

Treatment includes:

• Antibiotics for respiratory infections.
• Pancreatic enzymes to replace those that are missing.
• Vitamin supplements, especially vitamins A, D, E, and K.
• Inhaled bronchodilators, such as albuterol (Proventil, Ventolin), help open the airways.
• DNAse enzyme replacement therapy. The medication dornase (Pulmozyme) contains an enzyme that thins the mucus and makes it easier to cough up.
• Pain relievers. Research has shown that the pain reliever ibuprofen may slow lung deterioration in some children with cystic fibrosis. The results were most dramatic in children ages 5 to 13.
• Postural drainage and chest percussion.
• Lung transplant may be considered in some cases.
• Support Groups

The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition.

• Aztreonam (Brand name: Cayston)To improve respiratory symptoms in cystic fibrosis (CF) patients with Pseudomonas aeruginosa
• Ivacaftor (Brand name: Kalydeco)ivacaftor (KALYDECO) received expanded approval for the treatment of cystic fibrosis (CF) in patients age 12 months and older who have one mutation  in the CFTR gene that is responsive to ivacaftor potentiation based on clinical and/or in vitro assay data. It is a cystic fibrosis transmembrane conductance regulator (CFTR) potentiator.
• Lumacaftor/ivacaftor (Brand name: Orkambi)lumacaftor/ivacaftor (Orkambi) received expanded approval for the treatment of cystic fibrosis (CF) in patients age 2 years and older who are homozygous for the F508del mutation in the CFTR gene.
• Dornase alfa (Brand name: Pulmozyme®)
• Tezacaftor and Ivacaftor combination therapy (Brand name: Symdeko)
• Tobramycin for inhalation (Brand name: Tobi®)

Expectations (prognosis)

Disease registries now show that 40% of patients with cystic fibrosis are over age 18.

Today, the average life span for those who live to adulthood is approximately 35 years, a dramatic increase over the last three decades.

Death is usually caused by lung complications.

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CFTR protein in EYFP

Complications

• The most common complications are chronic respiratory infections.
• Pneumonia, recurrent
• Pneumothorax
• Coughing up blood
• Chronic respiratory failure
• Cor pulmonale
• Liver disease
• Diabetes
• Osteoporosis and arthritis

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Cystic fibrosis foundation

Prevention

There is no way to prevent cystic fibrosis. Screening of family members of a cystic fibrosis patient may detect the cystic fibrosis gene in between 60 and 90% of carriers, depending on the test used. Frequently asked questions

Frequently Asked Questions About Cystic Fibrosis

1. Can CF be cured? Currently, there is no cure for Cystic Fibrosis (CF). However, treatments are available to manage symptoms and improve the quality of life for those living with the condition.

2. Can CF patients have babies? Yes, some women with CF can have babies, although they may face fertility challenges. Men with CF are usually infertile due to blockage or absence of the vas deferens, but assisted reproductive technologies can help them become fathers.

3. Is cystic fibrosis always fatal? CF is a progressive and life-shortening disease, but advances in treatment and care have significantly improved the life expectancy and quality of life for people with the condition.

4. Who gets cystic fibrosis the most? CF is most common in people of Caucasian descent, particularly those with Northern European ancestry.

5. How does Covid affect cystic fibrosis? People with CF may be at higher risk of severe illness if they contract COVID-19, as they often have pre-existing lung issues and weakened immune systems. It is important for CF patients to follow recommended precautions to reduce their risk of infection.

6. What are 5 symptoms of cystic fibrosis? Five common symptoms of CF include:

1. Persistent cough with thick mucus
2. Frequent lung infections
3. Difficulty breathing or shortness of breath
4. Failure to gain weight or slow growth in children
5. Salty-tasting skin

7. What does cystic fibrosis do to a person? CF affects various organs, particularly the lungs and pancreas, by causing the production of thick, sticky mucus. This mucus can lead to lung infections, breathing difficulties, and issues with digestion and nutrient absorption.

8. How old is the oldest living person with CF? The age of the oldest living person with CF varies and is continually changing as life expectancy improves. Some people with CF have lived into their 50s and beyond.

9. At what age do cystic fibrosis symptoms start? CF symptoms can start as early as infancy, although the onset and severity of symptoms vary among individuals. Some people may not experience symptoms until later in life.

10. Can you live a long life with cystic fibrosis? While CF is a life-shortening disease, advances in treatments and care have significantly improved life expectancy and quality of life for people with the condition. Some people with CF live into their 40s, 50s, or even beyond.

11. What is the life expectancy of someone who has cystic fibrosis? The life expectancy for someone with CF varies depending on factors such as the severity of the condition, the individual's overall health, and access to appropriate care. The median life expectancy for CF patients in the United States is currently in the early 40s, but it continues to improve with advances in treatment.==External links==

• Cystic Fibrosis Foundation
• Cystic Fibrosis community which has forums, blogs, articles, and much more
• CF World Wide
• Liv For a Cure: A foundation dedicated to finding a cure for Cystic Fibrosis
• Recent medical research at the Cystic Fibrosis Foundation
• GeneTests GeneReview on Cystic Fibrosis
• Cystic fibrosis pictures (Univ Geneva, Switzerland)
• My So Called Lungs: A Young Girl's Diary of Living with Dying from Cystic Fibrosis
• Cystic Fibrosis in Australia - official website of Cystic Fibrosis Australia.
• Search the GeneCards database for CF related genes
• Detailed ICD-9-CM 277.* subsection
• Rare Diseases Clinical Research Network

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Cystic fibrosis is a rare disease.