title: [Early manifestations of cystic fibrosis in a premature patient with complex meconium ileus at birth].
abstract: OBJECTIVE
  To report a case of a preterm infant with complex meconium ileus at birth and cystic fibrosis.
  
  
  METHODS
  A male infant was born by vaginal delivery at 33 weeks and 5 days of gestational age with respiratory distress and severe abdominal distension. The exploratory laparotomy in the first day of life identified meconium ileus and secondary peritonitis. Ileal resection and ileostomy were performed, followed by reconstruction of the bowel transit at 20 days of life. At 11 days of life, the first immunoreactive trypsinogen (IRT) was 154 ng/mL (reference value=70), and oral pancreatic enzymes replacement therapy was started. After 23 days, the second IRT was 172 ng/mL (reference value=70). At 35 days of age he was discharged with referrals to primary care and to a special clinic for CF for the determination of sweat chloride. He was received in the outpatient clinic for neonatal screening for CF at 65 days of life presenting malnutrition and respiratory distress. The sweat chloride test was performed, with a positive result (126mEq/L).
  
  
  CONCLUSIONS
  This case illustrates the rapid evolution of CF in a premature patient with complex Meconium ileus as the first clinical manifestation.
authors.affiliation: Escola de Medicina de Ribeirão Preto da Universidade de São Paulo (USP), Ribeirão Preto, SP, Brasil. Electronic address: irciampo@gmail.com.
authors.forename: Ieda Regina Lopes
authors.initials: IR
authors.lastname: del Ciampo
authors.affiliation: Escola de Medicina de Ribeirão Preto da Universidade de São Paulo (USP), Ribeirão Preto, SP, Brasil.
authors.forename: Tainara Queiroz
authors.initials: TQ
authors.lastname: Oliveira
authors.affiliation: Escola de Medicina de Ribeirão Preto da Universidade de São Paulo (USP), Ribeirão Preto, SP, Brasil.
authors.forename: Luiz Antonio
authors.initials: LA
authors.lastname: del Ciampo
authors.affiliation: Escola de Medicina de Ribeirão Preto da Universidade de São Paulo (USP), Ribeirão Preto, SP, Brasil.
authors.forename: Regina
authors.initials: R
authors.lastname: Sawamura
authors.affiliation: Escola de Medicina de Ribeirão Preto da Universidade de São Paulo (USP), Ribeirão Preto, SP, Brasil.
authors.forename: Lidia Alice Gomes Monteiro Marin
authors.initials: LA
authors.lastname: Torres
authors.affiliation: Escola de Medicina de Ribeirão Preto da Universidade de São Paulo (USP), Ribeirão Preto, SP, Brasil.
authors.forename: Albin Eugenio
authors.initials: AE
authors.lastname: Augustin
authors.affiliation: Escola de Medicina de Ribeirão Preto da Universidade de São Paulo (USP), Ribeirão Preto, SP, Brasil.
authors.forename: Maria Inez Machado
authors.initials: MI
authors.lastname: Fernandes
mesh_terms: D003550:Cystic Fibrosis / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis*; D007415:Intestinal Obstruction / Q000209:etiology; D008297:Male; D008470:Meconium
keywords: Cystic fibrosis; Fibrose cística; Meconium ileus; Prematuridade; Prematurity; Íleo meconial