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| ==Overview== | | ==Overview== |
| The [[differential diagnosis]] of wheezing is wide, and the cause of wheezing in a given patient is determined by considering the characteristics of the wheezes and the historical and clinical findings made by the examining physician. | | The [[differential diagnosis]] of wheezing is wide, and the cause of wheezing in a given patient is determined by considering the characteristics of the wheezes and the historical and clinical findings made by the examining physician. |
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| ==Complete Differential Diagnosis of the Causes of Wheeze==
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| '''(In alphabetical order)'''
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| *Abnormal arytenoid movement
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| *[[Allergic bronchopulmonary aspergillosis]] ABPA
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| *[[Alpha 1-Antitrypsin Deficiency]]
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| *Amyloid deposition
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| *[[Anaphylaxis]]
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| *[[Angioedema]]
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| *[[Aspergillosis]] including [[aspergilloma]] and ABPA
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| *[[Aspiration]](foreign particles or foods)
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| *[[Asthma]] including status asthmaticus
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| *Benign airway [[tumors]] including:
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| **Bronchial adenomata syndrome
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| **Unknown ([[hamartoma]], [[clear cell]], [[teratoma]])
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| **Epithelial ([[papilloma]], [[polyps]])
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| **Mesodermal ([[fibroma]], [[lipoma]], [[leiomyoma]], [[chondroma]], granular cell tumor, sclerosing [[hemangioma]])
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| **Other (myofibroblastic tumor, xanthoma, [[amyloid]], mucosa-associated lymphoid tumor)
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| *[[Bronchiectasis]]
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| *[[Bronchiolitis]] (a common childhood disease)
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| *[[Bronchiolitis obliterans]]
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| *[[Bronchitis]] (usually viral, bacterial only in patients with tracheostomy or endotracheal intubation)
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| **[[influenza]] A and B
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| **[[parainfluenza]]
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| **[[coronavirus]] (types 1-3)
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| **[[rhinovirus]]
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| **[[respiratory syncytial virus]]
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| **human metapneumovirus
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| **Other:
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| ***[[Mycoplasma pneumoniae]]
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| ***[[Chlamydophila pneumoniae]]
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| ***[[Pertussis]]
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| *[[Bronchopulmonary dysplasia]]
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| *[[Byssinosis]] - cotton duct
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| *[[Carcinoid syndrome]]
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| *Cardiac asthma (including cardiogenic pulmonary edema)
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| *[[Cardiomegaly]] (severe cardiomegaly)
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| *Chemical poisoning (more than 50 substances have been linked to wheezing)
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| *[[Chondromalacia]]
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| *[[Chronic obstructive pulmonary disease]]: Chronic bronchitis and Emphysema
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| *Cold induced [[wheezing]] (Paediatrics)
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| *[[Ciliary dyskinesia]]-bronchiectasis
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| *[[Congenital abnormalities]] affecting the bronchial tree
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| *Cricoarytenoid arthritis
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| *[[Cystic fibrosis]]
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| *Descending aortic [[aneurysm]]
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| *Dialyzer hypersensitivity syndrome
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| *Esophageal foreign body
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| *Exercise-induced [[asthma]]
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| *Extrinsic allergic [[alveolitis]]
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| *Food allergies: numerous including:
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| **[[Peanut]] Allergy
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| *[[Gastroesophageal Reflux Disease]] (with aspiration)
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| *[[Graft-versus-host disease]]
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| *[[Hay fever]]
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| *[[Heart failure]] (see cardiogenic pulmonary edema and cardiac asthma)
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| *[[Hemorrhage]], pulmonary
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| *Hypertrophied [[tonsils]]
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| *[[Immunodeficiency]]
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| *[[Infection]] ([[pneumonia]])
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| *[[Interstitial lung disease]]
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| *Intrathoracic [[goiter]]
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| *[[Klebsiella]] rhinoscleroma
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| *[[Laryngeal edema]]
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| *[[Laryngocele]]
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| *Laryngostenosis
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| *[[Laryngotracheobronchitis]]
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| *[[Lymphadenopathy]] with large lymphnodes compressing the tracheal tree.
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| *Lymphangitic carcinomatosis
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| *[[Malignancy]] (bronchogenic)
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| **[[Squamous cell carcinoma]] with variants: papillary, clear cell, small cell, basaloid
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| **[[Small cell carcinoma]]
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| **[[Adenocarcinoma]]
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| ***Acinar
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| ***Papillary
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| ***Bronchioloalveolar carcinoma
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| ****Non-mucinous (Clara cell/type II pneumocyte type)
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| ****Mucinous (Goblet cell type)
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| ****Mixed mucinous and non-mucinous (Clara cell/type II pneumocyte/goblet cell type) or indeterminate
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| ***Solid adenocarcinoma with mucin formation
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| ***Mixed
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| ***Variants: well-differentiated fetal adenocarcinoma, mucinous ("colloid"), mucinous cystadenocarcinoma, signet ring, clear cell
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| **Large cell carcinoma with variants: large cell neuroendocrine carcinoma, combined large cell neuroendocrine carcinoma, basaloid carcinoma, lymphoepithelioma-like carcinoma, clear cell carcinoma, large cell carcinoma with rhaboid phenotype
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| **Adenosquamous carcinoma
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| **Carcinomas with pleomorphic, sarcomatoid, or sarcomatous elements
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| ***Carcinomas with spindle and/or giant cells
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| ***Pleomorphic carcinoma
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| ***Spindle cell carcinoma
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| ***Giant cell carcinoma
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| ***Carcinosarcoma
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| ***Blastoma (Pulmonary blastoma)
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| **Carcinoid tumor
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| ***Typical carcinoid
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| ***Atypical carcinoid
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| **Carcinomas of salivary gland type
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| ***Mucoepidermoid carcinoma
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| ***Adenoid cystic carcinoma
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| **Unclassified carcinoma
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| **[[Mastocytosis]]
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| **[[Mendelson's syndrome]] (aspiration pneumonitis)
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| *Medication-induced bronchoconstriction
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| **[[ACE inhibitors]] ( cough or rarely Angioneurotic edema and wheeze)
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| **[[Sotalol]]
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| **[[Adenosine]]
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| **[[Beta blockers]]: Common; usually occurs in patients with asthma or COPD; 1-selective agents, [[labetalol]], [[esmolol]], and [[pindolol]] are better tolerated than nonselective agents.
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| **[[Dipyridamole]] (IV form only)
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| **[[Protamine]]
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| **[[NSAIDs]] includign aspirin
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| **[[Marijuana]] (chronic use)
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| *[[Milk allergy]]
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| *Mobile supraglottic soft tissue
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| *[[Obesity]]
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| *[[Parasitic infections]]
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| **[[Ascariasis]]
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| **[[Hookworm]]
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| **Paragonimiases - lung infection
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| **[[Strongyloidiasis]]
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| **[[Toxocariasis]]
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| *Paroxysmal vocal cord motion
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| *Postextubation [[granuloma]]
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| *Postlobectomy bronchial torsion
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| *Postnasal drip syndrome
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| *Postradiation [[stenosis]]
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| *[[Primary ciliary dyskinesia]]
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| *[[Psychogenic]] wheezing
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| *[[Pulmonary edema]] (cardiogenic or non-cardiogenic)
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| *[[Pulmonary embolism]]
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| *[[Pulmonary eosinophilia]]
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| *[[Relapsing polychondritis]]
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| *Retained [[foreign body]] (trachea or esophagus)
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| *[[Retropharyngeal abscess]]
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| *Right sided [[aortic arch]]
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| *[[Sinusitis]] ( chronic sinusitis )
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| *Supraglottitis
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| *[[Tracheal stenosis]]
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| *[[Tracheobronchitis]]
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| *[[Tracheobronchomegaly]]
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| *Tracheobronchopathia osteoplastica : a rare, benign condition and is characterized by the presence of bony and cartilaginous nodules in the tracheal and bronchial mucosa.
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| *[[Tracheomalacia]]
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| *[[Tuberculosis]], Pulmonary
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| *Vascular compression and rings ( Aberrant subclavian artery abnormality )
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| *Vocal cord dysfunction
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| *Vocal cord hematoma
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| *Vocal cord paralysis (bilateral paralysis)
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| *[[Wegener's granulomatosis]]
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| [[Image:Asthma before-after.png|thumb|center|350px|'''Inflamed airways and bronchoconstriction in asthma'''. Airways narrowed as a result of the inflammatory response cause wheezing.]]
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| == References == | | == References == |