Fibrocystic disease of the pancreas presenting with acute salt depletion.

During the hot summer of 1948, 10 patients were admitted to the Babies' 1Ipspital in New York with heat prostration. No fewer than five of these children were cases of fibrocystic disease of the pancreas. Two further cases were discovered in subsequent summers. Reporting this interesting observation, Kessler and Andersen (1951) recorded that this special susceptibility to heat occurred in children who from the point of view of the fibrocystic disease seemed to be doing well; indeed, one child was thought to be normal and it was only in later investigations that he was found to have any underlying disease. Clinically the cases presented with vomiting, pyrexia and dehydration. Two children perspired freely, and in the two cases in which the observation was made low plasma chlorides were found on admission, namely, 59 and 81 mEq./litre (335 and 526 mg. per 100 ml.). Stimulated by this work, Di Sant'Agnese, Darling, Perera and Shea (1953) measured the quantity and electrolyte composition of the sweat in cases of fibrocystic disease. No difference in the volume of sweat was noted between the children with the disease and controls and great individual variations were observed in both groups. The electrolyte content of the sweat, however, was significantly higher in children with fibrocystic disease (Table 1). Di Sant'Agnese and his colleagues gave details of a further six cases of heat prostration in children with fibrocystic disease occurring in the summer of