What condition should a specialist suspect for a child with a sweat chloride level of 88 mEq/L?

A sweat chloride level of 88 mEq/L is suggestive of cystic fibrosis, a genetic disorder caused by mutations in the CFTR gene. In this condition, the sweat glands produce abnormally high levels of chloride and sodium, which is reflected in elevated sweat chloride tests.

Typically, a sweat chloride level above 60 mEq/L is considered indicative of cystic fibrosis, with levels above 80 mEq/L being highly suggestive. Therefore, a result of 88 mEq/L falls well within the diagnostic criteria for cystic fibrosis, leading to strong suspicion that this condition is present in the child.

The other conditions listed do not have a direct correlation with elevated sweat chloride levels. Diabetes mellitus does not affect sweat composition to this extent, pleural effusion pertains to fluid in the pleural space and is unrelated to sweat chloride levels, and asthma is a respiratory condition characterized by bronchoconstriction and airway inflammation but does not produce elevated sweat chloride as a hallmark finding. The specific elevated sweat chloride is a critical indicator of cystic fibrosis, which is why this diagnosis is the most appropriate response.