Sweat collection by iontophoresis
CPT4 code
Name of the Procedure:
Sweat Collection by Iontophoresis
Summary
Sweat collection by iontophoresis is a non-invasive procedure used to stimulate and collect sweat from a patient’s skin for testing purposes. This method uses a mild electrical current to drive chemicals, typically pilocarpine, into the skin to induce sweating.
Purpose
The procedure is mainly used to diagnose cystic fibrosis (CF) by measuring the chloride content in the sweat. Abnormally high levels of chloride can indicate CF, aiding in early diagnosis and management.
Indications
- Suspected cystic fibrosis, indicated by symptoms such as frequent lung infections, chronic coughing, and difficulty gaining weight.
- Family history of cystic fibrosis.
- Newborn screening tests that suggest the possibility of cystic fibrosis.
Preparation
- No special preparation, fasting, or medication adjustments are typically required.
- The patient should ensure the target skin area is clean and free of lotions or creams.
Procedure Description
- The procedure begins by cleaning the skin area, usually the forearm.
- Small electrodes and a special solution containing pilocarpine are applied to the skin.
- A weak electrical current is applied through the electrodes for about 5 minutes to stimulate sweat glands.
- After stimulation, the electrodes and solution are removed, and sweat is collected using a special gauze or collection device.
- The collected sweat is then sent to a lab for analysis.
Tools: Electrodes, pilocarpine solution, sweat collection device Anesthesia/Sedation: Not required as the procedure is typically painless
Duration
The entire procedure takes approximately 30 to 60 minutes.
Setting
Typically performed in a hospital outpatient clinic or specialized diagnostic center.
Personnel
- A trained healthcare professional, such as a clinical nurse or a lab technician, performs the procedure.
- A doctor may oversee the process and interpret the results.
Risks and Complications
- Mild skin irritation or a tingling sensation during the electrical stimulation.
- Rarely, allergic reaction to pilocarpine may occur.
Benefits
- Provides valuable diagnostic information for cystic fibrosis, allowing for early intervention and management.
- Non-invasive and painless, with minimal discomfort.
Recovery
- No specific recovery needed; the patient can resume normal activities immediately.
- Follow-up appointments may be necessary to discuss test results and next steps.
Alternatives
- Genetic testing for cystic fibrosis mutations.
- Newborn screening blood tests. Pros: Can provide genetic information Cons: May not be as specific as the sweat chloride test in diagnosing CF
Patient Experience
- The patient might feel mild tingling during electrical stimulation but typically no pain.
- Comfort measures include ensuring the stimulation is mild and reassuring the patient about the procedure’s safety.