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 | Immunodeficiencies |
Studies for connective tissue diseases Anti-nuclear antibodies (ANA) Angiotensin-converting enzyme (ACE) Anti-neutrophil cytoplasmic (ANCA) Anti-glomerular basement membrane (GBM) | Autoimmune diseases Sarcoidosis 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 |