In a child, a combination of malnutrition, steatorrhea, chronic respiratory infection, thyroid deficiency, a great salt loss through the skin and functional disturbances in secretary mechanisms of various glands is indicative of:

CYSTIC FIBROSIS Cystic fibrosis is an autosomal recessive condition. The defective exocrine gland function leads to microobstruction of the pancreas, which results in cystic degeneration of the pancreas and, ultimately, a digestive enzyme deficiency producing malabsorption of nutrients. The defective gene products cause abnormal water and electrolyte transport across epithelial cells, which results in a chronic disease of the respiratory and gastrointestinal system, elevated levels of electrolytes in sweat, and impaired reproductive function.   The incidence of dental caries in children with cystic fibrosis is low secondary to long-term antibiotic therapy, buffering capacity of excess calcium in the saliva, and pancreatic enzyme replacement therapy. There is a high incidence of mouth breathing and open-bite malocclusion associated with chronic nasal and sinus obstruction. Patients with cystic fibrosis may prefer to be treated in a more upright position to allow them to clear secretions more easily. The use of sedative agents that interfere with pulmonary function should be avoided, and the patient’s physician should be contacted before nitrous oxide-oxygen sedation is used in a patient exhibiting evidence of severe emphysema. Reference: McDONALD AND AVERY’S DENTISTRY for the CHILD and ADOLESCENT, 10th ed page no 533