ARCHIVES OF DISEASE IN CHILDHOOD The Journal of the Royal College of Paediatrics and Child Health Annotations

Diagnosing cystic fibrosis: blood, sweat, and tears Making a diagnosis of cystic fibrosis has lifelong implica-tions and repercussions for the aVected individual, their family, and the many people they will encounter through-out their lives. Clearly, the decision needs to be made accurately and as early as possible. A late diagnosis is often preceded by a catalogue of hospital visits, family anguish, anger, and guilt and a delay in the initiation of early treat-ment may have an impact on long term outcome.1 Equally disturbing is a small but increasing experience in cystic fibrosis clinics of the child, diagnosed as having cystic fibrosis, whom on review—often years later—is found to be normal.2 In most instances the decision is easy: a child has suggestive clinical symptoms or a family history and posi