title: Sweat test practice in pediatric pulmonology after introduction of cystic fibrosis newborn screening.
abstract: The influence of the generalization of cystic fibrosis newborn screening (CFNBS) in France on sweat test (ST) prescription is unknown. In this French retrospective, descriptive, and multicenter study, we studied the indications, number, methods, and results of STs prescribed by a pediatric pulmonologist in children who had a negative CFNBS and an ST for respiratory symptoms in 2012. We included 502 children with 523 STs, performed with four different methods. The main indication was asthma (71.3 %), then chronic cough (52.4 %), atypical lower airway infections (42.2 %), and bronchiectasis (7 %). Four children had a diagnosis of CF (0.8 %), all presenting with chronic productive cough and recurrent respiratory infections.
  
  
  CONCLUSIONS
  Asthma is the most frequent indication of ST in our cohort. Because of the systematic CFNBS in France, some prescriptions should be avoided, particularly in case of severe or moderate asthma with no other associated symptom. Moreover, methods of STs often do not follow the guidelines and need standardization.
  
  
  BACKGROUND
  • Newborn screening (NBS) has become the most frequent circumstance of the diagnosis of cystic fibrosis (CF) in France after its generalization. • The prescription of sweat test (ST) in children with respiratory symptoms who already had a negative NBS has not been studied.
  
  
  BACKGROUND
  • In children with a negative CF NBS referred to a university hospital for respiratory diseases, despite important variations of ST methods, only 4 children among 502 have been diagnosed as CF. • Despite recommendations, ST prescription should be avoided in children with moderate to severe asthma and no other associated symptom.
authors.affiliation: Service de pneumologie pédiatrique et CRCM, CHU Timone, 264 rue St Pierre, 13005, Marseille, France. celine.grimaldi@ap-hm.fr.
authors.forename: Céline
authors.initials: C
authors.lastname: Grimaldi
authors.affiliation: Département de pédiatrie, Hôpital des enfants, 31026, Toulouse, France. bremont.f@chu-toulouse.fr.
authors.forename: François
authors.initials: F
authors.lastname: Brémont
authors.affiliation: Service de pédiatrie et CRCM pédiatrique, Hôpitaux pédiatriques de Nice CHU-Lenval, 06200, Nice, France. berlioz-baudoin.m@pediatrie-chulenval-nice.fr.
authors.forename: Michèle
authors.initials: M
authors.lastname: Berlioz-Baudoin
authors.affiliation: Service de pédiatrie, CHU Caen, 14033, Caen, France. brouard-j@chu-caen.fr.
authors.forename: Jacques
authors.initials: J
authors.lastname: Brouard
authors.affiliation: Service de pédiatrie et pneumologie, Hôpital d'Enfants Armand-Trousseau, AP-HP, 75571, Paris, France. harriet.corvol@trs.aphp.fr.
authors.forename: Harriet
authors.initials: H
authors.lastname: Corvol
authors.affiliation: Département de pédiatrie médicale, CHU Hôpitaux de Rouen, 76031, Rouen, France. laure.couderc@chu-rouen.fr.
authors.forename: Laure
authors.initials: L
authors.lastname: Couderc
authors.affiliation: Service de pneumologie et allergologie pédiatriques, Hôpital Necker Enfants Malades, AP-HP, 75015, Paris, France. guillaume.lezmi@nck.aphp.fr.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Lezmi
authors.affiliation: Département de pédiatrie-Centre mucoviscidose, CHU de Grenoble, Hôpital Albert Michallon, 38043, Grenoble, France. IPin@chu-grenoble.fr.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Pin
authors.affiliation: CRCM mixte, CHU Estaing, 63003, Clermont-Ferrand, France. ipetit@chu-clermontferrand.fr.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Petit
authors.affiliation: Département de pneumologie pédiatrique, Hôpital Femme Mère Enfant, CHU de Lyon, 69500, Bron, France. philippe.reix@chu-lyon.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Reix
authors.affiliation: Département de pédiatrie, Centre Hospitalier Intercommunal de Créteil, 94010, Créteil, France. Natacha.Remus@chicreteil.fr.
authors.forename: Natacha
authors.initials: N
authors.lastname: Remus
authors.affiliation: Service de médecine infantile, Hôpital d'enfants de Nancy, Rue du Morvan, 54511, Vandoeuvre-Les-Nancy, France. c.schweitzer@chu-nancy.fr.
authors.forename: Cyril
authors.initials: C
authors.lastname: Schweitzer
authors.affiliation: Service de pneumologie pédiatrique, Pôle enfant Hôpital Jeanne de Flandre, CHRU de Lille, 59037, Lille, France. caroline.thumerelle@chru-lille.fr.
authors.forename: Caroline
authors.initials: C
authors.lastname: Thumerelle
authors.affiliation: Service de pneumologie pédiatrique et CRCM, CNRS-URMITE 6236, CHU Timone, 264 rue St Pierre, 13005, Marseille, France. jean-christophe.dubus@ap-hm.fr.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Dubus
mesh_terms: D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000175:diagnosis*; D019005:Cystic Fibrosis Transmembrane Conductance Regulator / Q000235:genetics; D005260:Female; D005602:France; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D015272:Pulmonary Medicine; D012189:Retrospective Studies; D013542:Sweat / Q000737:chemistry*
chemical_list: D019005:Cystic Fibrosis Transmembrane Conductance Regulator
keywords: Pediatric pulmonology; Prescription; Respiratory symptoms; Sweat test