ACUTE METABOLIC ALKALOSIS IN CYSTIC-FIBROSIS - PROSPECTIVE-STUDY AND REVIEW OF THE LITERATURE

Between January 1993 and April 1994, 5 patients with cystic fibrosis, aged 4-9 months, were admitted to the Department of Pediatrics, Univer sity of Berne, Switzerland, with acute, severe metabolic alkalosis (so dium < 133 mmol/l, plasma potassium < 3.5, chloride < 85, bicarbonate > 35.0 mmol/l, blood pH > 7.43). 87 cases of acute metabolic alkalosis complicating cystic fibrosis reported in the literature between 1951 and 1995 were also reviewed. Our cases and those described in the lite rature demonstrate that acute metabolic alkalosis occurs in patients a ged 2 years or less. Anorexia, vomiting, respiratory exacerbation, fev er, and body weight loss often precede metabolic alkalosis. Furthermor e, metabolic alkalosis is a common initial presentation of cystic fibr osis, suggesting that this diagnosis should be considered in the conte xt of unexplained metabolic alkalosis.