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Cystic Fibrosis Message Board


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My 7 year old son saw the lung specialist today and he said that he has grade 1 finger clubbing and his lung functions tests were not great. He's also underweight for his height. We're waiting to take the sodium chloride test on Monday. I really don't see anything different about his fingers. Can anyone tell me anything about this? Is it possible to have all of these these signs and NOT have CF??
[QUOTE=suki1724;3941440]My 7 year old son saw the lung specialist today and he said that he has grade 1 finger clubbing and his lung functions tests were not great. He's also underweight for his height. We're waiting to take the sodium chloride test on Monday. I really don't see anything different about his fingers. Can anyone tell me anything about this? Is it possible to have all of these these signs and NOT have CF??[/QUOTE]
Hi suki!

Clubbing is a medical phenomenon which is seen in a variety of conditions. It's very hard to describe in words--you have to see it. Go to google image and type in clubbing to get an idea what a clubbed finger looks like. The nails almost look "swollen". There is an objective definition of the condition, but it won't mean anything if you don't have medical training.

Clubbing is often associated with medical conditions where there is a chronic amount of pus or infection hanging around for a long time for example:
Cystic fibrosis and other conditions resulting in bronchiectasis
lung abscess
liver abscess
bacterial endocarditis (an infection of a heart valve)
inflammatory bowel disease

Or it can be seen in conditions where organs are scarred:

idiopathic pulmonary fibrosis
liver cirrhosis

Or in conditions where there is chronically low oxygen in the blood:
cyanotic heart disease
...uhhh, and I can't think of any more.

With your son and cystic fibrosis, there is constantly thick, tenuous secretions which eventually lead to destruction of the small airways in his lungs and these are areas where pus can hang out for long periods of time. This is why chest physiotherapy is so important for children/adults with CF.

Okay, after all of that, the fact that your child has clubbing is only an ancilliary symptom which goes along with the CF. It doesn't mean it's any worse or any better--it's just an associated finding.
Thanks for the response.

We haven't had the sodium chloride test yet, it's on Monday. I was just trying to find out if he could be having these symptoms and NOT have CF.

He's seven years old and I would have thought that it would have been diagnosed before now.

Thanks again,

Susan
[QUOTE=suki1724;3942898]Thanks for the response.

We haven't had the sodium chloride test yet, it's on Monday. I was just trying to find out if he could be having these symptoms and NOT have CF.

He's seven years old and I would have thought that it would have been diagnosed before now.

Thanks again,

Susan[/QUOTE]
That's a good point. Sorry, I thought you meant had already HAD been diagnosed. There are kids who can get diagnosed later than average if their CFTR mutation (the one that gives you CF) doesn't "penetrate through" as strongly. These children will tend to have milder disease that is possibly diagnosed later.

There are plenty of other things that can cause clubbing aside from CF (I gave you a bit of a list there). They will probably check the oxygen levels in his blood and some cardiac studies (all non-invasive) to rule out cyanotic heart disease IF the CF testing is negative. There are people who have clubbing where a cause is never found as well.





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