Differential diagnosis
The differential includes:
- extrinsic allergic alveolitis:
- there is a history of exposure to organic dusts
- the upper lobes are usually most involved
- RF, ANF, raised gamma-globulin present in fibrosing alveolitis
- bronchiectasis:
- cough is longstanding and productive of purulent sputum
- transfer factor is not reduced
- there is usually airway obstruction and dyspnoea
- chronic left heart failure
- sarcoidosis
- lymphangitis carcinomatosa
- pulmonary embolism
- industrial lung disease
- idiopathic pulmonary haemosiderosis
- histiocytosis X
- tuberous sclerosis.
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