Pneumoconiosis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dushka Riaz, MD

Overview

Pneumoconiosis must be differentiated from other diseases that cause chronic cough and dyspnea.

Differentiating Pneumoconiosis from other Diseases

Pneumoconiosis must be differentiated from other diseases that cause cough and dyspnea.

Differentiating pneumoconiosis from other diseases on the basis of dyspnea and cough

On the basis of cough and chronic dyspnea, pneumoconiosis must be differentiated from lung malignancy, tuberculosis, emphysema, asthma, interstitial lung disease, pneumonia, and sarcoidosis. [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19] [20] [21] [22]

Diseases Clinical manifestations Para-clinical findings Gold standard
Symptoms Physical examination
Lab Findings Imaging
Chronic Dyspnea Cough Fever Spirometry Auscultation Night Sweats CBC ABG Imaging
Pneumoconiosis + + + ↑ FEV1/FVC Wheezing, rhonchi, crackles + ↑WBC ↓O2, ↑CO2 Massive fibrosis, hilar adenopathy, reticular opacities, pleural plaques HRCT
Lung Malignancy + + - ↓Vt, ↑RV Wheezing, crackles + Normal Normal Mass lesion, hilar lymphadenopathy Bronchoscopy
Tuberculosis + + + Restrictive, obstructive, or mixed Wheezing, rhonchi, crackles + ↑WBC ↓O2, ↑CO2 Patchy consolidation, nodular opacities IFN-y assay and acid fast stain
Emphysema + + - ↓ FEV1/FVC Wheezing - Normal Respiratory alkalosis, Metabolic acidosis Flat diaphragm Physical exam, spirometry
Asthma + + - ↓ FEV1/FVC Wheezing - ↑ Eosinophil Respiratory alkalosis, Metabolic acidosis Normal Physical exam, spirometry before and after bronchodilator
Interstitial lung diseases + + - ↑ FEV1/FVC Wheezing, rhonchi, crackles +/- Normal ↓O2, ↑CO2 Peripheral pulmonary infiltrative opacification HRCT
Sarcoidosis + + - ↑ FEV1/FVC Crackles + Normal ↓O2, ↑CO2 Hilar adenopathy HRCT
Pneumonia + + + Normal Wheezing, rhonchi, crackles + ↑WBC, neutrophilia Normal Lobar consolidation CXR, CT Scan

References

  1. ↑ Cotes JE, Field GB (1972). "Lung gas exchange in simple pneumoconiosis of coal workers". Br J Ind Med. 29 (3): 268–73. doi:10.1136/oem.29.3.268. PMC 1009422. PMID 5044598.
  2. ↑ Cullinan P, Reid P (2013). "Pneumoconiosis". Prim Care Respir J. 22 (2): 249–52. doi:10.4104/pcrj.2013.00055. PMC 6442808. PMID 23708110.
  3. ↑ "StatPearls". 2021. PMID 32310362 Check |pmid= value (help).
  4. ↑ Farzaneh MR, Jamshidiha F, Kowsarian S (2010). "Inhalational lung disease". Int J Occup Environ Med. 1 (1): 11–20. PMID 23022777.
  5. ↑ Arakawa H, Johkoh T, Honma K, Saito Y, Fukushima Y, Shida H; et al. (2007). "Chronic interstitial pneumonia in silicosis and mix-dust pneumoconiosis: its prevalence and comparison of CT findings with idiopathic pulmonary fibrosis". Chest. 131 (6): 1870–6. doi:10.1378/chest.06-2553. PMID 17400659.
  6. ↑ Stark P, Jacobson F, Shaffer K (1992). "Standard imaging in silicosis and coal worker's pneumoconiosis". Radiol Clin North Am. 30 (6): 1147–54. PMID 1410305.
  7. ↑ Cox CW, Rose CS, Lynch DA (2014). "State of the art: Imaging of occupational lung disease". Radiology. 270 (3): 681–96. doi:10.1148/radiol.13121415. PMID 24568704.
  8. ↑ "StatPearls". 2021. PMID 29493979.
  9. ↑ Balla MM, Desai S, Purwar P, Kumar A, Bhandarkar P, Shejul YK; et al. (2016). "Differential diagnosis of lung cancer, its metastasis and chronic obstructive pulmonary disease based on serum Vegf, Il-8 and MMP-9". Sci Rep. 6: 36065. doi:10.1038/srep36065. PMC 5095766. PMID 27811960.
  10. ↑ Restrepo CS, Katre R, Mumbower A (2016). "Imaging Manifestations of Thoracic Tuberculosis". Radiol Clin North Am. 54 (3): 453–73. doi:10.1016/j.rcl.2015.12.007. PMID 27153783.
  11. ↑ Loddenkemper R, Lipman M, Zumla A (2015). "Clinical Aspects of Adult Tuberculosis". Cold Spring Harb Perspect Med. 6 (1): a017848. doi:10.1101/cshperspect.a017848. PMC 4691808. PMID 25659379.
  12. ↑ "StatPearls". 2021. PMID 29489292.
  13. ↑ Price DB, Yawn BP, Jones RC (2010). "Improving the differential diagnosis of chronic obstructive pulmonary disease in primary care". Mayo Clin Proc. 85 (12): 1122–9. doi:10.4065/mcp.2010.0389. PMC 2996146. PMID 21123639.
  14. ↑ Khalili M, Wong RJ (2018). "Underserved Does Not Mean Undeserved: Unfurling the HCV Care in the Safety Net". Dig Dis Sci. 63 (12): 3250–3252. doi:10.1007/s10620-018-5316-9. PMC 6436636. PMID 30311153.
  15. ↑ Ullmann N, Mirra V, Di Marco A, Pavone M, Porcaro F, Negro V; et al. (2018). "Asthma: Differential Diagnosis and Comorbidities". Front Pediatr. 6: 276. doi:10.3389/fped.2018.00276. PMC 6178921. PMID 30338252.
  16. ↑ "StatPearls". 2021. PMID 31082128.
  17. ↑ Prasse A (2016). "The Diagnosis, Differential Diagnosis, and Treatment of Sarcoidosis". Dtsch Arztebl Int. 113 (33–34): 565–74. doi:10.3238/arztebl.2016.0565. PMC 5015588. PMID 27598883.
  18. ↑ Ungprasert P, Ryu JH, Matteson EL (2019). "Clinical Manifestations, Diagnosis, and Treatment of Sarcoidosis". Mayo Clin Proc Innov Qual Outcomes. 3 (3): 358–375. doi:10.1016/j.mayocpiqo.2019.04.006. PMC 6713839 Check |pmc= value (help). PMID 31485575.
  19. ↑ "StatPearls". 2021. PMID 28613460.
  20. ↑ "StatPearls". 2021. PMID 30020693.
  21. ↑ "StatPearls". 2021. PMID 28613500.
  22. ↑ "StatPearls". 2021. PMID 30252372.

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