Salt depletion in patients with cystic fibrosis (CF) who reside in hot or arid climates1 is a recognized and perhaps not uncommon occurrence, but hyponatremia, hypochloremia, and metabolic alkalosis are uncommon manifestations of CF in infancy, particularly during cold weather. We describe two infants with previously undiagnosed CF who had electrolyte depletion, metabolic alkalosis, and dehydration in the winter and three infants known to have CF in whom similar manifestations developed.
Clinical Data.—In December 1977 and February 1978, two infants with previously undiagnosed conditions (patients 1 and 2) were referred to Rainbow Babies and Childrens Hospital, Cleveland, because of vomiting and dehydration. The acute symptoms appeared one week prior to admission and were accompanied by a mild cough and wheezing in both patients and mild diarrhea of several days' duration in patient 2. These infants lived in northeastern Ohio and western Pennsylvania. This was the first hospitalization for patient