Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1979 Feb;54(2):92–97. doi: 10.1136/adc.54.2.92

Screening for cystic fibrosis in the newborn by meconium analysis.

H C Ryley, L M Neale, T D Brogan, P T Bray
PMCID: PMC1545355  PMID: 312055

Abstract

During a 4-year routine screening programme for cystic fibrosis (CF) 15 464 specimens were examined for raised meconium albumin levels by a test strip method and by electroimmunoassay. The incidence of false-positive results was about 5 per 1000 specimens in either test. This could be reduced by 90% by determining the ratio of albumin : alpha-1-trypsin inhibitor (a ratio below 2.0 being considered as a negative result), and it could be reduced to zero by determining the ratio in subsequent faecal specimens. Three of 12 meconium specimens from infants with proved CF gave false-negative results in all 3 tests. The other 9 specimens had greater than 100 mg albumin/g dry weight and albumin: alpha-1-trypsin inhibitor ratios of greater than 3.0; in subsequent faecal specimens the ratios were over 4.0. 176 meconium specimens from elsewhere in the UK were examined and these included 23 from infants who were subsequently proved to have CF. Six of these 23 CF specimens gave false-negative results, the other 17 being strongly positive. The origins of meconium serum protein suggest that infants with CF in whom meconium gives false-negative results have normal pancreatic functions at birth. The specificity of current meconium tests therefore cannot be improved as they depend on pancreatic dysfunction.

Full text

PDF
92

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Gitlin D., Kumate J., Morales C., Noriega L., Arévalo N. The turnover of amniotic fluid protein in the human conceptus. Am J Obstet Gynecol. 1972 Jul 1;113(5):632–645. doi: 10.1016/0002-9378(72)90632-1. [DOI] [PubMed] [Google Scholar]
  2. Griffiths A. D., Bull F. E., Dykes P. Effect of gestational length on albumin content of meconium. Arch Dis Child. 1976 Apr;51(4):321–323. doi: 10.1136/adc.51.4.321. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Huang N. N., Macri C. N., Girone J., Sproul A. Survival of patients with cystic fibrosis. Am J Dis Child. 1970 Oct;120(4):289–295. doi: 10.1001/archpedi.1970.02100090063002. [DOI] [PubMed] [Google Scholar]
  4. Kollberg H., Hellsing K. Screening for cystic fibrosis by analysis of albumin in meconium. Acta Paediatr Scand. 1975 May;64(3):477–482. doi: 10.1111/j.1651-2227.1975.tb03868.x. [DOI] [PubMed] [Google Scholar]
  5. Orenstein D. M., Boat T. F., Stern R. C., Tucker A. S., Charnock E. L., Matthews L. W., Doershuk C. F. The effect of early diagnosis and treatment in cystic fibrosis: a seven-year study of 16 sibling pairs. Am J Dis Child. 1977 Sep;131(9):973–975. doi: 10.1001/archpedi.1977.02120220039005. [DOI] [PubMed] [Google Scholar]
  6. Prosser R., Owen H., Bull F., Parry B., Smerkinich J., Goodwin H. A., Dathan J. Screening for cystic fibrosis by examination of meconium. Arch Dis Child. 1974 Aug;49(8):597–601. doi: 10.1136/adc.49.8.597. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Rule A. H., Baran D. T. Quantitative determination of water-soluble proteins in meconium. Pediatrics. 1970 May;45(5):847–850. [PubMed] [Google Scholar]
  8. Ryley H. C., Neale L. M., Brogan T. D., Bray P. T. Screening for cystic fibrosis by analysis of meconium for albumin and protease inhibitors. Clin Chim Acta. 1975 Oct 15;64(2):117–125. doi: 10.1016/0009-8981(75)90193-x. [DOI] [PubMed] [Google Scholar]
  9. Ryley H. C., Neale L. M., Prosser R., Dodge J. Screening for cystic fibrosis by analysis of serum protein in faeces. Arch Dis Child. 1976 Aug;51(8):641–643. doi: 10.1136/adc.51.8.641. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Schutt W. H., Isles T. E. Protein in meconium from meconium ileus. Arch Dis Child. 1968 Apr;43(228):178–181. doi: 10.1136/adc.43.228.178. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Schuttringer G., Zinterhofer L. Automated immunoprecipitation of meconium albumin for cystic fibrosis screening in the newborn. Clin Chim Acta. 1978 Feb 1;83(1-2):109–116. doi: 10.1016/0009-8981(78)90213-9. [DOI] [PubMed] [Google Scholar]
  12. Shwachman H., Redmond A., Khaw K. T. Studies in cystic fibrosis. Report of 130 patients diagnosed under 3 months of age over a 20-year period. Pediatrics. 1970 Sep;46(3):335–343. [PubMed] [Google Scholar]
  13. Stephan U., Busch E. W., Kollberg H., Hellsing K. Cystic fibrosis detection by means of a test-strip. Pediatrics. 1975 Jan;55(1):35–38. [PubMed] [Google Scholar]
  14. Stern R. C., Boat T. F., Doershuk C. F., Tucker A. S., Primiano F. P., Jr, Matthews L. W. Course of cystic fibrosis in 95 patients. J Pediatr. 1976 Sep;89(3):406–411. doi: 10.1016/s0022-3476(76)80537-9. [DOI] [PubMed] [Google Scholar]
  15. WISER W. C., BEIER F. R. ALBUMIN IN THE MECONIUM OF INFANTS WITH CYSTIC FIBROSIS: A PRELIMINARY REPORT. Pediatrics. 1964 Jan;33:115–119. [PubMed] [Google Scholar]
  16. Warwick W. J. Respiratory complications of cystic fibrosis. Prevention. Minn Med. 1969 Sep;52(9):1567–1569. [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES