Cystic fibrosis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[2]

Differentiating X from other Diseases

Differential diagnosis of cough with wheezes is :

Diseases	Symptoms			Signs			Diagosis
	Fever	Cough	Chest pain	Wheezes	Crackles	Tachypnea	Lab tests	Imaging
Asthma	-	Dry/Productive	-	+	-	+	Lab tests to exclude other diseases. Serum examination shows elevated level of eosinophils due to allergy.	CT scan shows: Dilated bronchi. Bronchial wall thickening. Air trapping.
Bronchiolitis	+/-	Dry	-	+	+	+/-	ELISA and immunoassays may be done in case of RSV infection. Pulmonary function test to exclude other lung diseases.	CT scan shows: Intense bronchiolar mural inflammation. bronchial wall thickening. Centrilobular nodules with tree-in-bud pattern.
COPD	+	Productive	-	+	+	+	Spirometry: FEV1/FVC < 70%. Arterial blood gases: hypoxemia and hypercapnia. Sputum culture.	EKG may show: P pulmonale. right ventricular hypertrophy. Narrow QRS. CT scan is more sensitive in diagnosing COPD than X ray.
Bacterial pneumonia	+	Productive	+	+	+	+/-	Diagnosis depends on presentation and physical examination. Laboratory tests: arterial blood gases may show hypoxia and acidosis. Sputum culture.	X ray is performed to detect: pleural effusion. Inflitrates within the lungs. CT scan shows: Consolidation. Ground glass appearance.
Cystic Fibrosis	+/-	Productive	+/-	-	-	+	Cystic fibrosis transmembrane conductance regulator (CFTR) dysfunction evidenced by : Elevated sweat chloride ≥60 mmol/L (on two occasions). Presence of two disease-causing mutations in CFTR, one from each parental allele. References