title: Clinical and mutation profile of children with cystic fibrosis in Jammu and Kashmir.
abstract: OBJECTIVE
  To study the clinical and mutation profiles of children with cystic fibrosis in Jammu and Kashmir.
  
  
  METHODS
  One hundred consecutive patients presenting with one or more phenotypic features suggestive of cystic fibrosis (CF) were screened by quantitative sweat chloride testing. For patients with positive/equivocal test result on two occasions, CFTR gene mutation analysis was done by polymerase chain reaction.
  
  
  RESULTS
  Of the 100 patients, 18 (10 females) were diagnosed to have CF at a median age of 10.5 y (IQR 4.75-15.25 y) while the median age at the onset of symptoms was 12 mo (IQR 4-63 mo) with a delay in diagnosis by 102.4±80.5 months. Clinical features at presentation included failure to thrive (94.4%), chronic cough (78%), recurrent pneumonia (61%), persistent pneumonia (11%), and chronic diarrhea (50%). Positive sweat chloride (>60 meq/L) was seen in 14 (14%) patients and 4 (4%) patients had equivocal (40-60 meq/L) value on two different occasions. Mutational analysis done in 15 patients showed DeltaF508 mutation in 20% (3/15) patients in homozygous form and in 13% (2/15) patients in heterozygous form. Intron 19 mutation 3849+10kb C>T was found in 40% (6/15) in heterozygous form. One (6.6%) patient had DeltaF508 and 3849+10kbC>T mutations in compound heterozygous form. Patients with equivocal sweat chloride and 3849+10kbC>T mutation had delayed onset of pulmonary involvement.
  
  
  CONCLUSIONS
  3849 +10kbC>T mutation appears to be common in children with cystic fibrosis in Jammu and Kashmir followed by DeltaF508, although the data are quite limited. Although presentation is delayed and sweat chloride is in the equivocal range, severe lung involvement may occur in these patients.
authors.affiliation: Department of Pediatrics, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India and *Department of Genetics, All India Institute of Medical Sciences, New Delhi, India. Correspondence to: Prof Mushtaq Ahmad Bhat, Department of Pediatrics, Sheri Kashmir Institute of Medical Sciences, Srinagar Kashmir, India. mbhat47@rediffmail.com.
authors.forename: Masarat Sultana
authors.initials: MS
authors.lastname: Kawoosa
authors.forename: Mushtaq Ahmad
authors.initials: MA
authors.lastname: Bhat
authors.forename: Syed Wajid
authors.initials: SW
authors.lastname: Ali
authors.forename: Imran
authors.initials: I
authors.lastname: Hafeez
authors.forename: Shivram
authors.initials: S
authors.lastname: Shastri
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics* / Q000382:microbiology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D009154:Mutation / Q000235:genetics*