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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