An 8-year-old boy presents with bilateral pale nasal polyps causing mouth breathing and hyponasal speech. Skin tests for allergy are negative. Which additional evaluation is indicated before planning surgery?
- A Serum IgE level against Aspergillus fumigatus
- B Nasal biopsy for acid-fast bacilli
- C Sweat chloride testing ✓
- D Serum ACE levels
Correct answer: C. Sweat chloride testing
Explanation
Nasal polyposis is distinctly uncommon in young children, and bilateral polyps in a paediatric patient mandate exclusion of cystic fibrosis, in which inspissated secretions and chronic inflammation produce polyps. Sweat chloride testing remains the standard screening test. Allergic fungal sinusitis typically shows allergic mucin and hyperdense CT changes, mycobacterial disease causes granulomas rather than pale polyps, and serum ACE relates to sarcoidosis, which presents with granulomatous nasal lesions, not classical polyposis.
Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.