Cystic Fibrosis and Congenital Pancreatic Insufficiency

Abstract

Response: We note with interest the comments of Drs. Alaswad and Rose, in particular the reference to the association of CF mutations and chronic pancreatitis. We have not tested the patient described in our report in January 1999 for CF mutations. Six months ago, coeliac disease was diagnosed in her 3-year-old brother. His duodenal biopsy specimen showed the unequivocal histological features of coeliac disease, and all coeliac antibodies were positive. He responded well to a gluten-free diet but, like his elder sister, his stools did not recover completely, and stool chymotrypsin levels were found to be reduced. He has now been given pancreatic supplements, and his stools and growth have improved. He awaits formal pancreatic function tests, and we will test both siblings for CF mutations. Khalid Khan Sally G. Mitton St. George's Hospital Medical School; London, United Kingdom