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Table 4 Differential diagnosis: predisposing systemic disorders

From: Pediatric hypersensitivity pneumonitis: literature update and proposal of a diagnostic algorithm

Sweat test

Cystic fibrosis

Cardiological evaluation (ECG, echocardiogram)

Congenital heart disease

Cultures or tests for infectious aetiology

Lung infections

Oesophagal transit X-ray, pH-impedancemetry

Recurrent aspiration (GERD, dysphagia, anatomical abnormalities)

Immunity studies

IgA-M-G; recall Ag; HIV

Lymphocyte subpopulations; Complement


Studies for connective tissue diseases

Anti-nuclear antibodies (ANA)

Angiotensin-converting enzyme (ACE)

Anti-neutrophil cytoplasmic (ANCA)

Anti-glomerular basement membrane (GBM)

Autoimmune diseases


Vasculitis (e.g., Wegener syndrome, Churg-Strauss syndrome, microscopic polyangiitis)

Anti-GBM syndrome (Goodpasture syndrome)

Serum and urinary amino acids

Lysosomal storage diseases

Protein intolerance with lysinuria

Genetics for surfactant dysfunctional diseases

Deficit of surfactant production and metabolism

Bronchoscopy, BAL and lung biopsy

Infections, aspiration, Langerhans cell histiocytosis, alveolar haemorrhage, pulmonary alveolar proteinosis