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Cyclic Fluctuation of Sweat Electrolytes in Women: Effect of Polythiazide Upon Sweat Electrolytes

Cyclic Fluctuation of Sweat Electrolytes in Women: Effect of Polythiazide Upon Sweat Electrolytes Abstract Spontaneous fluctuations in sweat electrolyte levels were studied in 57 women, including 21 mothers of children with cystic fibrosis (C/F mothers), and in nine men, to determine the effect of the menstrual cycle upon sweat salinity and to see if differences were apparent between C/F heterozygotes and controls. Sweat sodium and chloride concentrations, but not potassium, followed a cyclic pattern in 50% of the premenopausal women. The cyclic fluctuations appeared to follow the known hormonal pattern of the menstrual cycle with both "ovulatory" and "premenstrual" peaks of sweat salinity. Oral administration of a thiazide diuretic prevented or reversed the cyclic rise in sweat salinity, suggesting that the cyclic phenomenon is related to salt and water retention during the menstrual cycle. A single "sweat test" is inadequate for the detection of genetic heterozygotes for cystic fibrosis, because of the variability of sweat salinity. A greater percentage of C/F mothers had occasional sweat chloride determinations above 40 mEq/L than did the controls. Persistently high sweat salinity in an adult may be an indication of the genetic abnormality. References 1. Lieberman, J., and Kellogg, F.: Evaluation of the Sweat Chloride Assay in Adults: Use of Pilocarpine Iontophoresis , Amer J Med Sci 246:537-549, ( (Nov) ) 1963.Crossref 2. Gibson, L.E., and Cooke, R.E.: A Test for Concentration of Electrolytes in Sweat in Cystic Fibrosis of the Pancreas Utilizing Pilocarpine by Iontophoresis , Pediatrics 23:545-549 ( (March) ) 1959. 3. Cotlove, E.; Trantham, H.V.; and Bowman, R.L.: An Instrument and Method for Automatic Rapid, Accurate and Sensitive Titration of Chloride in Biological Samples , J Lab Clin Med 51:461-468 ( (March) ) 1958. 4. di Sant'Agnese, P.A.: Recent Observations on Pathogenesis of Cystic Fibrosis of the Pancreas , Pediatrics 24:313-321 ( (Aug) ) 1959. 5. Thorn, G.W.; Nelson, K.R.; and Thorn, D.W.: A Study of the Mechanism of Edema Associated With Menstruation , Endocrinology 22:155-163 ( (Feb) ) 1938.Crossref 6. Bruce, J., and Russell, G.F.M.: Premenstrual Tension: A Study of Weight Changes and Balances of Water, Sodium, and Potassium , Lancet 2:267-271 ( (Aug 11) ) 1962.Crossref 7. Landau, R.L., et al: The Metabolic Effects of Progesterone in Man , J Clin Endocr 15:1194-1215 ( (Oct) ) 1955.Crossref 8. Landau, R.L., et al: The Relationship of Estrogen and of Pituitary Hormones to the Metabolic Effects of Progesterone , J Clin Endocr 17:177-185 ( (Feb) ) 1957.Crossref 9. Landau, R.L., et al: The Metabolic Effects of Progesterone in Man: Dose Response Relationships , J Lab Clin Med 50:613-620 ( (Oct) ) 1957. 10. Landau, R.L.; Plotz, E.J.; and Lugibihl, K.: Effect of Pregnancy on the Metabolic Influence of Administered Progesterone , J Clin Endocr 20:1561-1567 ( (Dec) ) 1960.Crossref 11. Lobeck, C.C.; Barta, R.A.; and Mangos, J.A.: Study of Sweat in Pitressin Resistant Diabetes Insipidus , J Pediat 62:868-875 ( (June) ) 1963.Crossref 12. Weber, J.W., and Gautier, E.: Pitressin resistenter Diabetes insipidus, Therapie mit Salidiuretica , Helv Paediat Acta 16:565 ( (Dec) ) 1961. 13. Kalayci, M.N., and Gibbs, G.: The Influence of Chlorothiazide on Chloride Secretion by Sweat Glands , Amer J Dis Child 102:620 ( (Oct) ) 1961. 14. Conn, J.W.: Aldosteronism in Man , JAMA 183:775-781 ( (March 2) ) 1963.Crossref 15. Siegenthaler, P.P., and Haller, R. de: Contribution au probleme du diagnostic de la fibrose kystique du pancreas ou mucoviscidose chez l'adulte , Helv Med Acta 32:1-33, ( (April) ) 1965. 16. Oliver, W.I., and Watson, D.F.: Effect of Salt Intake on Sweat Electrolytes in Children , Amer J Dis Child 107:470-475, ( (May) ) 1964. 17. Schwartz, I.L., and Thaysen, J.H.: Excretion of Sodium and Potassium in Human Sweat , J Clin Invest 35:114-120, ( (Jan) ) 1956.Crossref 18. Cage, G.W., and Dobson, R.L.: Sodium Secretion and Reabsorption in the Human Eccrine Sweat Gland , J Clin Invest 44:1270-1276 ( (Aug) ) 1965.Crossref 19. Slegers, J.F.G.: The Secretory Mechanism of the Eccrine Sweat Gland , Acta Physiol Pharmacol Neerl 12:302 (No. (3) ) 1963. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Cyclic Fluctuation of Sweat Electrolytes in Women: Effect of Polythiazide Upon Sweat Electrolytes

JAMA , Volume 195 (8) – Feb 21, 1966

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References (19)

Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.1966.03100080069018
Publisher site
See Article on Publisher Site

Abstract

Abstract Spontaneous fluctuations in sweat electrolyte levels were studied in 57 women, including 21 mothers of children with cystic fibrosis (C/F mothers), and in nine men, to determine the effect of the menstrual cycle upon sweat salinity and to see if differences were apparent between C/F heterozygotes and controls. Sweat sodium and chloride concentrations, but not potassium, followed a cyclic pattern in 50% of the premenopausal women. The cyclic fluctuations appeared to follow the known hormonal pattern of the menstrual cycle with both "ovulatory" and "premenstrual" peaks of sweat salinity. Oral administration of a thiazide diuretic prevented or reversed the cyclic rise in sweat salinity, suggesting that the cyclic phenomenon is related to salt and water retention during the menstrual cycle. A single "sweat test" is inadequate for the detection of genetic heterozygotes for cystic fibrosis, because of the variability of sweat salinity. A greater percentage of C/F mothers had occasional sweat chloride determinations above 40 mEq/L than did the controls. Persistently high sweat salinity in an adult may be an indication of the genetic abnormality. References 1. Lieberman, J., and Kellogg, F.: Evaluation of the Sweat Chloride Assay in Adults: Use of Pilocarpine Iontophoresis , Amer J Med Sci 246:537-549, ( (Nov) ) 1963.Crossref 2. Gibson, L.E., and Cooke, R.E.: A Test for Concentration of Electrolytes in Sweat in Cystic Fibrosis of the Pancreas Utilizing Pilocarpine by Iontophoresis , Pediatrics 23:545-549 ( (March) ) 1959. 3. Cotlove, E.; Trantham, H.V.; and Bowman, R.L.: An Instrument and Method for Automatic Rapid, Accurate and Sensitive Titration of Chloride in Biological Samples , J Lab Clin Med 51:461-468 ( (March) ) 1958. 4. di Sant'Agnese, P.A.: Recent Observations on Pathogenesis of Cystic Fibrosis of the Pancreas , Pediatrics 24:313-321 ( (Aug) ) 1959. 5. Thorn, G.W.; Nelson, K.R.; and Thorn, D.W.: A Study of the Mechanism of Edema Associated With Menstruation , Endocrinology 22:155-163 ( (Feb) ) 1938.Crossref 6. Bruce, J., and Russell, G.F.M.: Premenstrual Tension: A Study of Weight Changes and Balances of Water, Sodium, and Potassium , Lancet 2:267-271 ( (Aug 11) ) 1962.Crossref 7. Landau, R.L., et al: The Metabolic Effects of Progesterone in Man , J Clin Endocr 15:1194-1215 ( (Oct) ) 1955.Crossref 8. Landau, R.L., et al: The Relationship of Estrogen and of Pituitary Hormones to the Metabolic Effects of Progesterone , J Clin Endocr 17:177-185 ( (Feb) ) 1957.Crossref 9. Landau, R.L., et al: The Metabolic Effects of Progesterone in Man: Dose Response Relationships , J Lab Clin Med 50:613-620 ( (Oct) ) 1957. 10. Landau, R.L.; Plotz, E.J.; and Lugibihl, K.: Effect of Pregnancy on the Metabolic Influence of Administered Progesterone , J Clin Endocr 20:1561-1567 ( (Dec) ) 1960.Crossref 11. Lobeck, C.C.; Barta, R.A.; and Mangos, J.A.: Study of Sweat in Pitressin Resistant Diabetes Insipidus , J Pediat 62:868-875 ( (June) ) 1963.Crossref 12. Weber, J.W., and Gautier, E.: Pitressin resistenter Diabetes insipidus, Therapie mit Salidiuretica , Helv Paediat Acta 16:565 ( (Dec) ) 1961. 13. Kalayci, M.N., and Gibbs, G.: The Influence of Chlorothiazide on Chloride Secretion by Sweat Glands , Amer J Dis Child 102:620 ( (Oct) ) 1961. 14. Conn, J.W.: Aldosteronism in Man , JAMA 183:775-781 ( (March 2) ) 1963.Crossref 15. Siegenthaler, P.P., and Haller, R. de: Contribution au probleme du diagnostic de la fibrose kystique du pancreas ou mucoviscidose chez l'adulte , Helv Med Acta 32:1-33, ( (April) ) 1965. 16. Oliver, W.I., and Watson, D.F.: Effect of Salt Intake on Sweat Electrolytes in Children , Amer J Dis Child 107:470-475, ( (May) ) 1964. 17. Schwartz, I.L., and Thaysen, J.H.: Excretion of Sodium and Potassium in Human Sweat , J Clin Invest 35:114-120, ( (Jan) ) 1956.Crossref 18. Cage, G.W., and Dobson, R.L.: Sodium Secretion and Reabsorption in the Human Eccrine Sweat Gland , J Clin Invest 44:1270-1276 ( (Aug) ) 1965.Crossref 19. Slegers, J.F.G.: The Secretory Mechanism of the Eccrine Sweat Gland , Acta Physiol Pharmacol Neerl 12:302 (No. (3) ) 1963.

Journal

JAMAAmerican Medical Association

Published: Feb 21, 1966

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