CYSTIC-FIBROSIS OF THE PANCREAS REVEALED BY WATER DEPLETION WITH HYPOCHLORONATREMIC ALKALOSIS IN 3 INFANTS AND ONE NEWBORN

Background. - Acute dehydration with hypochloronatremic metabolic alka losis is a classical complication of cystic fibrosis of the pancreas. Its progressive development as a revealing manifestation of the diseas e is rare as is its appearance in newborns. Case n degrees 1. - A 13 m onth-old girl was admitted because of status epilepticus. She was seve rely dehydrated (20% weight loss) but had normal diuresis. Investigati ons showed metabolic alkalosis, hypochloronatremia and hypokalemia. Al l the manifestations disappeared within 5 days with treatment but thre e sweat tests were abnormal. Case n degrees 2. - A 7 month-old girl wa s admitted because she suffered from progressive loss of weight (10%); she was dehydrated and had metabolic alkalosis plus hypochloronatremi a, but her diuresis was normal. Two sweat tests were abnormal. Case n degrees 3.-A 4.5 month-old boy was admitted because he suffered from s evere (12%) weight loss. His diuresis was normal despite dehydration; metabolic alkalosis and hypochloronatremia, larrelmia were found. Two subsequent sweat tests were abnormal. Case n degrees 4. - A 3 day-old girl was admitted suffering from meconium ileus. Two initial mechanism analysis for protein were abnormal. She had a cardiorespiratory arres t on the 13(th) day of life when she had lost 14% of her birth weight; investigations showed metabolic alkalosis, hyponatremia (83 mEq/l), h ypochloremia (45 mEq/l); kalemia was 5.9 mEq/l. Peritoneal dialysis wa s needed to correct hydroelectrolytic changes. A sweat test performed on the 26(th) day of life was also abnormal. Investigations performed during the periods of dehydration, and repeated later, showed transien t functional kidney failure. None of the four patients had any respira tory or gastrointestinal clinical manifestations of cystic fibrosis. C onclusion. - Metabolic alkalosis with hypochloronatremia plus progress ive, severe dehydration in infants whose diuresis is paradoxically nor mal must be followed by examination for cystic fibrosis.