Cystic fibrosis differential diagnosis: Difference between revisions
Jump to navigation
Jump to search
Usama Talib (talk | contribs) |
Ahmed Younes (talk | contribs) No edit summary |
||
(13 intermediate revisions by 2 users not shown) | |||
Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Cystic_fibrosis]] | |||
{{CMG}}; {{AE}} {{SHH}} | {{CMG}}; {{AE}} {{SHH}}, {{KZ}}, {{Anmol}} | ||
==Overview== | ==Overview== | ||
Cystic fibrosis has to be differentiated from other conditions with similar presentation of cough and | Cystic fibrosis has to be differentiated from other conditions with similar presentation of [[cough]] and [[wheeze]] like [[Acute viral nasopharyngitis (common cold)|common cold]], [[asthma]], [[bronchiolitis]], [[emphysema]], [[Primary ciliary dyskinesia|primary ciliary dyskinesia]] ([[Kartagener's Syndrome|Kartagener syndrome]]), [[bronchitis]], [[bronchiectasis]], [[Pulmonary aspiration|foreign body aspiration]], [[pneumoconiosis]], [[interstitial lung disease]], cardiogenic [[pulmonary edema]], [[Gastroesophageal reflux disease|GERD]] and [[sarcoidosis]]. | ||
[[ | |||
==Cough== | ==Cough== | ||
Cystic fibrosis must be differentiated from other diseases presenting with cough and wheeze | Cystic fibrosis must be differentiated from other diseases presenting with [[cough]] and [[wheeze]] include: | ||
{| class="wikitable" | {| class="wikitable" | ||
Line 317: | Line 144: | ||
* Pollution | * Pollution | ||
|- | |- | ||
| style="background:#DCDCDC;" align="center" + |''' | | style="background:#DCDCDC;" align="center" + |'''[[Primary ciliary dyskinesia|Primary Ciliary Dyskinesia]]''' | ||
'''([[Primary ciliary dyskinesia|Kartagener Syndrome]])''' | |||
| style="background:#F5F5F5;" align="center" + |Chronic | | style="background:#F5F5F5;" align="center" + |Chronic | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | * Years | ||
| style="background:#F5F5F5;" align="center" + |✔ | | style="background:#F5F5F5;" align="center" + |✔ | ||
| style="background:#F5F5F5;" align="center" + | | | style="background:#F5F5F5;" align="center" + |✔ | ||
| style="background:#F5F5F5;" align="center" + | | | style="background:#F5F5F5;" align="center" + |✔ | ||
| style="background:#F5F5F5;" align="center" + | - | | style="background:#F5F5F5;" align="center" + | - | ||
| style="background:#F5F5F5;" align="center" + |✔ | | style="background:#F5F5F5;" align="center" + |✔ | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* [[Wheeze|Wheezing]] | * [[Wheeze|Wheezing]] | ||
* [[ | * [[Rales|Crackles]] | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | * Low or absent amount of nasal [[nitric oxide]] (nNO). | ||
* | * [[Mucociliary clearance]] may be useful for [[screening]] | ||
* Confirmation with tests of ciliary function. | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | * [[Chest X-rays|Chest X-ray]] reveals : | ||
* [[Bronchial]] wall thickening. | |||
* [[Bronchiectasis]] and hyperinflation. | |||
* [[Cyst|Cystic]] [[bronchiectasis]] with air-fluid levels may be visible. | |||
* Usually involves the lower and middle lobes. | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | * Mild to moderate obstructive ventilatory defect | ||
* | * Not specific | ||
* May be normal | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* [[ | * [[Transmission electron microscopy|Transmission electron microscopy (TEM)]] for assessment of ciliary [[ultrastructure]] | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | * Recurrent [[Respiratory tract infection|respiratory infections]] | ||
* Poor sense of [[smell]] | |||
|- | |- | ||
| style="background:#DCDCDC;" align="center" + |[[Bronchiectasis|'''Bronchiectasis''']]<ref name="pmid166509702">{{cite journal |vauthors=King PT, Holdsworth SR, Freezer NJ, Villanueva E, Holmes PW |title=Characterisation of the onset and presenting clinical features of adult bronchiectasis |journal=Respir Med |volume=100 |issue=12 |pages=2183–9 |year=2006 |pmid=16650970 |doi=10.1016/j.rmed.2006.03.012 |url=}}</ref> | | style="background:#DCDCDC;" align="center" + |[[Bronchiectasis|'''Bronchiectasis''']]<ref name="pmid166509702">{{cite journal |vauthors=King PT, Holdsworth SR, Freezer NJ, Villanueva E, Holmes PW |title=Characterisation of the onset and presenting clinical features of adult bronchiectasis |journal=Respir Med |volume=100 |issue=12 |pages=2183–9 |year=2006 |pmid=16650970 |doi=10.1016/j.rmed.2006.03.012 |url=}}</ref> | ||
Line 399: | Line 235: | ||
* Exposure of tobacco and air pollution | * Exposure of tobacco and air pollution | ||
|- | |- | ||
| style="background:#DCDCDC;" align="center" + |''' | | style="background:#DCDCDC;" align="center" + |'''Foreign body [[Aspiration of foreign body|aspiration]]'''<ref name="pmid29221325">{{cite journal| author=Hewlett JC, Rickman OB, Lentz RJ, Prakash UB, Maldonado F| title=Foreign body aspiration in adult airways: therapeutic approach. | journal=J Thorac Dis | year= 2017 | volume= 9 | issue= 9 | pages= 3398-3409 | pmid=29221325 | doi=10.21037/jtd.2017.06.137 | pmc=5708401 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29221325 }}</ref><ref name="pmid11444115">{{cite journal |vauthors=Rafanan AL, Mehta AC |title=Adult airway foreign body removal. What's new? |journal=Clin. Chest Med. |volume=22 |issue=2 |pages=319–30 |year=2001 |pmid=11444115 |doi= |url=}}</ref><ref name="pmid26568942">{{cite journal| author=Haddadi S, Marzban S, Nemati S, Ranjbar Kiakelayeh S, Parvizi A, Heidarzadeh A| title=Tracheobronchial Foreign-Bodies in Children; A 7 Year Retrospective Study. | journal=Iran J Otorhinolaryngol | year= 2015 | volume= 27 | issue= 82 | pages= 377-85 | pmid=26568942 | doi= | pmc=4639691 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26568942 }}</ref> | ||
| style="background:#F5F5F5;" align="center" + |Acute | | style="background:#F5F5F5;" align="center" + |Acute | ||
| style="background:#F5F5F5;" align="center" + | | | style="background:#F5F5F5;" align="center" + | | ||
Line 455: | Line 291: | ||
* Children <2 years | * Children <2 years | ||
|- | |- | ||
| rowspan="3" |[[Parenchyma|'''Parenchyma''']] | | rowspan="3" style="background:#DCDCDC;" align="center" + |[[Parenchyma|'''Parenchyma''']] | ||
| style="background:#DCDCDC;" align="center" + |[[Cystic fibrosis|'''Cystic fibrosis''']] <ref name="pmid18639722">{{cite journal |vauthors=Farrell PM, Rosenstein BJ, White TB, Accurso FJ, Castellani C, Cutting GR, Durie PR, Legrys VA, Massie J, Parad RB, Rock MJ, Campbell PW |title=Guidelines for diagnosis of cystic fibrosis in newborns through older adults: Cystic Fibrosis Foundation consensus report |journal=J. Pediatr. |volume=153 |issue=2 |pages=S4–S14 |year=2008 |pmid=18639722 |pmc=2810958 |doi=10.1016/j.jpeds.2008.05.005 |url=}}</ref><ref name="pmid1285737">{{cite journal |vauthors=Kerem E, Reisman J, Corey M, Canny GJ, Levison H |title=Prediction of mortality in patients with cystic fibrosis |journal=N. Engl. J. Med. |volume=326 |issue=18 |pages=1187–91 |year=1992 |pmid=1285737 |doi=10.1056/NEJM199204303261804 |url=}}</ref> | | style="background:#DCDCDC;" align="center" + |[[Cystic fibrosis|'''Cystic fibrosis''']] <ref name="pmid18639722">{{cite journal |vauthors=Farrell PM, Rosenstein BJ, White TB, Accurso FJ, Castellani C, Cutting GR, Durie PR, Legrys VA, Massie J, Parad RB, Rock MJ, Campbell PW |title=Guidelines for diagnosis of cystic fibrosis in newborns through older adults: Cystic Fibrosis Foundation consensus report |journal=J. Pediatr. |volume=153 |issue=2 |pages=S4–S14 |year=2008 |pmid=18639722 |pmc=2810958 |doi=10.1016/j.jpeds.2008.05.005 |url=}}</ref><ref name="pmid1285737">{{cite journal |vauthors=Kerem E, Reisman J, Corey M, Canny GJ, Levison H |title=Prediction of mortality in patients with cystic fibrosis |journal=N. Engl. J. Med. |volume=326 |issue=18 |pages=1187–91 |year=1992 |pmid=1285737 |doi=10.1056/NEJM199204303261804 |url=}}</ref> | ||
| style="background:#F5F5F5;" align="center" + |Chronic | | style="background:#F5F5F5;" align="center" + |Chronic | ||
Line 610: | Line 446: | ||
| style="background:#F5F5F5;" align="center" + | -- | | style="background:#F5F5F5;" align="center" + | -- | ||
|- | |- | ||
| colspan="2 | | colspan="2" style="background:#DCDCDC;" align="center" + |[[Autoimmune disease|'''Autoinmune''']] | ||
| style="background:#DCDCDC;" align="center" + |[[Sarcoidosis|'''Sarcoidosis''']]<ref name="pmid27378039">{{cite journal |vauthors=Carmona EM, Kalra S, Ryu JH |title=Pulmonary Sarcoidosis: Diagnosis and Treatment |journal=Mayo Clin. Proc. |volume=91 |issue=7 |pages=946–54 |year=2016 |pmid=27378039 |doi=10.1016/j.mayocp.2016.03.004 |url=}}</ref><ref name="pmid12803116">{{cite journal |vauthors=Yanardağ H, Pamuk GE, Karayel T, Demirci S |title=Bone marrow involvement in sarcoidosis: an analysis of 50 bone marrow samples |journal=Haematologia (Budap) |volume=32 |issue=4 |pages=419–25 |year=2002 |pmid=12803116 |doi= |url=}}</ref> | | style="background:#DCDCDC;" align="center" + |[[Sarcoidosis|'''Sarcoidosis''']]<ref name="pmid27378039">{{cite journal |vauthors=Carmona EM, Kalra S, Ryu JH |title=Pulmonary Sarcoidosis: Diagnosis and Treatment |journal=Mayo Clin. Proc. |volume=91 |issue=7 |pages=946–54 |year=2016 |pmid=27378039 |doi=10.1016/j.mayocp.2016.03.004 |url=}}</ref><ref name="pmid12803116">{{cite journal |vauthors=Yanardağ H, Pamuk GE, Karayel T, Demirci S |title=Bone marrow involvement in sarcoidosis: an analysis of 50 bone marrow samples |journal=Haematologia (Budap) |volume=32 |issue=4 |pages=419–25 |year=2002 |pmid=12803116 |doi= |url=}}</ref> | ||
| style="background:#F5F5F5;" align="center" + |Chronic | | style="background:#F5F5F5;" align="center" + |Chronic | ||
Line 680: | Line 482: | ||
* Young adults | * Young adults | ||
* [[Skin]], [[joint]] and [[eye]] lesions | * [[Skin]], [[joint]] and [[eye]] lesions | ||
|} | |} | ||
Line 778: | Line 491: | ||
[[Category:Medicine]] | [[Category:Medicine]] | ||
[[Category: | [[Category:Up-To-Date]] | ||
[[Category:Gastroenterology]] | |||
[[Category:Pediatrics]] | |||
[[Category:Pulmonology]] |
Latest revision as of 19:22, 19 February 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[2], Karina Zavaleta, MD [3], Anmol Pitliya, M.B.B.S. M.D.[4]
Overview
Cystic fibrosis has to be differentiated from other conditions with similar presentation of cough and wheeze like common cold, asthma, bronchiolitis, emphysema, primary ciliary dyskinesia (Kartagener syndrome), bronchitis, bronchiectasis, foreign body aspiration, pneumoconiosis, interstitial lung disease, cardiogenic pulmonary edema, GERD and sarcoidosis.
Cough
Cystic fibrosis must be differentiated from other diseases presenting with cough and wheeze include:
Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Symptoms | Physical exam | ||||||||||||||
Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | ||||
Respiratory | Upper airway diseases | Common Cold[1] | Acute |
|
✔ | - | - | ✔ | - |
|
|
|
|
||
Lower airway | Asthma[2] | Chronic |
|
✔ Clear mucoid or yellow sputum | - | - | - | ✔ |
|
|
|
|
| ||
Acute Bronchitis[3] | Acute |
|
✔ | - | - | - | ✔ |
|
|
|
|
| |||
Chronic Bronchitis[4][5] | Chronic |
|
✔ Clear sputum | - | - | ✔ | ✔ |
|
|
|
| ||||
Primary Ciliary Dyskinesia | Chronic |
|
✔ | ✔ | ✔ | - | ✔ |
|
|
|
|
| |||
Bronchiectasis[6] | Chronic |
|
✔ Mucopurulent sputum | ✔ | - | ✔ |
|
|
|
| |||||
Emphysema [7] | Chronic |
|
✔ Mucoid or purulent sputum | - | - | ✔ | ✔ |
|
|
|
|
| |||
Foreign body aspiration[8][9][10] | Acute |
|
✔ | ✔ | - | ✔ | ✔ |
|
|
|
|
| |||
Bronchiolitis[11][12] | Acute |
|
✔ | - | ✔ | ✔ |
|
|
|
|
| ||||
Parenchyma | Cystic fibrosis [13][14] | Chronic |
|
✔ | - | ✔ | ✔ |
|
|
| |||||
Pneumoconioses[15][16] | Acute, Chronic |
|
- | - | ✔ | ✔ | ✔ |
|
|
||||||
Interstitial lung disease[17][18] | Chronic |
|
- | ✔ | ✔ | - | ✔ |
|
|
|
|
| |||
Cardiac | Cardiogenic pulmonary edema[19][20] | Acute |
|
✔ Pink frothy, liquid | - | ✔ | - | ✔ |
|
|
|
|
| ||
Gastrointestinal | Gastroesophageal reflux[21][22] | Chronic |
|
✔ | - | ✔ | - | ✔ |
|
|
|
|
-- | ||
Autoinmune | Sarcoidosis[23][24] | Chronic |
|
- | - | ✔ | ✔ | ✔ |
|
|
|
References
- ↑ Eccles R (2005). "Understanding the symptoms of the common cold and influenza". Lancet Infect Dis. 5 (11): 718–25. doi:10.1016/S1473-3099(05)70270-X. PMID 16253889.
- ↑ Ukena D, Fishman L, Niebling WB (2008). "Bronchial asthma: diagnosis and long-term treatment in adults". Dtsch Arztebl Int. 105 (21): 385–94. doi:10.3238/arztebl.2008.0385. PMC 2696883. PMID 19626179.
- ↑ Wenzel RP, Fowler AA (2006). "Clinical practice. Acute bronchitis". N. Engl. J. Med. 355 (20): 2125–30. doi:10.1056/NEJMcp061493. PMID 17108344.
- ↑ Brusasco V, Martinez F (2014). "Chronic obstructive pulmonary disease". Compr Physiol. 4 (1): 1–31. doi:10.1002/cphy.c110037. PMID 24692133.
- ↑ Qaseem A, Snow V, Shekelle P, Sherif K, Wilt TJ, Weinberger S, Owens DK (2007). "Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline from the American College of Physicians". Ann. Intern. Med. 147 (9): 633–8. PMID 17975186.
- ↑ King PT, Holdsworth SR, Freezer NJ, Villanueva E, Holmes PW (2006). "Characterisation of the onset and presenting clinical features of adult bronchiectasis". Respir Med. 100 (12): 2183–9. doi:10.1016/j.rmed.2006.03.012. PMID 16650970.
- ↑ Rossi A, Butorac-Petanjek B, Chilosi M, Cosío BG, Flezar M, Koulouris N; et al. (2017). "Chronic obstructive pulmonary disease with mild airflow limitation: current knowledge and proposal for future research - a consensus document from six scientific societies". Int J Chron Obstruct Pulmon Dis. 12: 2593–2610. doi:10.2147/COPD.S132236. PMC 5587130. PMID 28919728.
- ↑ Hewlett JC, Rickman OB, Lentz RJ, Prakash UB, Maldonado F (2017). "Foreign body aspiration in adult airways: therapeutic approach". J Thorac Dis. 9 (9): 3398–3409. doi:10.21037/jtd.2017.06.137. PMC 5708401. PMID 29221325.
- ↑ Rafanan AL, Mehta AC (2001). "Adult airway foreign body removal. What's new?". Clin. Chest Med. 22 (2): 319–30. PMID 11444115.
- ↑ Haddadi S, Marzban S, Nemati S, Ranjbar Kiakelayeh S, Parvizi A, Heidarzadeh A (2015). "Tracheobronchial Foreign-Bodies in Children; A 7 Year Retrospective Study". Iran J Otorhinolaryngol. 27 (82): 377–85. PMC 4639691. PMID 26568942.
- ↑ Bordley WC, Viswanathan M, King VJ, Sutton SF, Jackman AM, Sterling L, Lohr KN (2004). "Diagnosis and testing in bronchiolitis: a systematic review". Arch Pediatr Adolesc Med. 158 (2): 119–26. doi:10.1001/archpedi.158.2.119. PMID 14757603.
- ↑ "www.nice.org.uk".
- ↑ Farrell PM, Rosenstein BJ, White TB, Accurso FJ, Castellani C, Cutting GR, Durie PR, Legrys VA, Massie J, Parad RB, Rock MJ, Campbell PW (2008). "Guidelines for diagnosis of cystic fibrosis in newborns through older adults: Cystic Fibrosis Foundation consensus report". J. Pediatr. 153 (2): S4–S14. doi:10.1016/j.jpeds.2008.05.005. PMC 2810958. PMID 18639722.
- ↑ Kerem E, Reisman J, Corey M, Canny GJ, Levison H (1992). "Prediction of mortality in patients with cystic fibrosis". N. Engl. J. Med. 326 (18): 1187–91. doi:10.1056/NEJM199204303261804. PMID 1285737.
- ↑ Jp NA, Imanaka M, Suganuma N (2017). "Japanese workplace health management in pneumoconiosis prevention". J Occup Health. 59 (2): 91–103. doi:10.1539/joh.16-0031-RA. PMC 5478517. PMID 27980247.
- ↑ Weiland DA, Lynch DA, Jensen SP, Newell JD, Miller DE, Crausman RS, Kuhn C, Kern DG (2003). "Thin-section CT findings in flock worker's lung, a work-related interstitial lung disease". Radiology. 227 (1): 222–31. doi:10.1148/radiol.2271011063. PMID 12668748.
- ↑ Lama VN, Martinez FJ (2004). "Resting and exercise physiology in interstitial lung diseases". Clin. Chest Med. 25 (3): 435–53, v. doi:10.1016/j.ccm.2004.05.005. PMID 15331185.
- ↑ Chetta A, Marangio E, Olivieri D (2004). "Pulmonary function testing in interstitial lung diseases". Respiration. 71 (3): 209–13. doi:10.1159/000077416. PMID 15133338.
- ↑ Gheorghiade M, Zannad F, Sopko G, Klein L, Piña IL, Konstam MA, Massie BM, Roland E, Targum S, Collins SP, Filippatos G, Tavazzi L (2005). "Acute heart failure syndromes: current state and framework for future research". Circulation. 112 (25): 3958–68. doi:10.1161/CIRCULATIONAHA.105.590091. PMID 16365214.
- ↑ Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL (2013). "2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines". Circulation. 128 (16): e240–327. doi:10.1161/CIR.0b013e31829e8776. PMID 23741058.
- ↑ Kahrilas PJ, Hughes N, Howden CW (2011). "Response of unexplained chest pain to proton pump inhibitor treatment in patients with and without objective evidence of gastro-oesophageal reflux disease". Gut. 60 (11): 1473–8. doi:10.1136/gut.2011.241307. PMID 21508423.
- ↑ Badillo R, Francis D (2014). "Diagnosis and treatment of gastroesophageal reflux disease". World J Gastrointest Pharmacol Ther. 5 (3): 105–12. doi:10.4292/wjgpt.v5.i3.105. PMC 4133436. PMID 25133039.
- ↑ Carmona EM, Kalra S, Ryu JH (2016). "Pulmonary Sarcoidosis: Diagnosis and Treatment". Mayo Clin. Proc. 91 (7): 946–54. doi:10.1016/j.mayocp.2016.03.004. PMID 27378039.
- ↑ Yanardağ H, Pamuk GE, Karayel T, Demirci S (2002). "Bone marrow involvement in sarcoidosis: an analysis of 50 bone marrow samples". Haematologia (Budap). 32 (4): 419–25. PMID 12803116.