Cystic fibrosis (CF), an autosomal recessive disorder, significantly affects the function of exocrine glands. This genetically inherited disease is characterized by the production of thick and sticky mucus, which can severely affect various organs and systems in the body.
CF is primarily caused by a genetic mutation in a chromosome 7 gene coding for the cystic fibrosis transmembrane conductance regulator (CFTR) protein. The most common gene mutation leading to CF is the ΔF508 mutation, but over 2000 different mutations of this gene may lead to the disease. The result of these mutations is a decreased chloride secretion and increased sodium resorption, leading to thicker mucus secretions.
The most commonly affected organs by CF are sinuses, lungs, pancreas, biliary and hepatic systems, intestines, and sweat glands. Sinus disease occurs when the increased viscosity of secretions obstructs the sinus ostia. Lung disease, a common manifestation of CF, occurs due to mucus plugging in the bronchioles, leading to obstructive lung disease. Symptoms associated with lung disease include chronic bronchitis, abnormal pulmonary function tests, bronchiectasis, and colonization with Pseudomonas aeruginosa.
The pancreas also suffers from CF, leading to pancreatic insufficiency, recurrent pancreatitis, and early-onset diabetes. Hepatobiliary manifestations include focal biliary cirrhosis, cholelithiasis, periportal fibrosis, liver cirrhosis, portal hypertension, and variceal bleeding. CF can also cause musculoskeletal issues, hematologic abnormalities, nephrogenic manifestations, and dermatologic conditions.
The diagnosis of CF is based on the presence of symptoms, a positive family history, and confirmatory tests such as elevated sweat chloride, two disease-causing CFTR mutations, and abnormal nasal potential difference.
Cystic fibrosis is a complex genetic disorder affecting multiple body organs and systems. By understanding its causes, etiology, organ impacts, and available treatments, healthcare providers can improve the quality of life for those affected.
From Chapter 20:
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